Lumbar drainage for the treatment of refractory intracranial hypertension in HIV-negative cryptococcal meningitis

Future Microbiol. 2019 Jul:14:859-866. doi: 10.2217/fmb-2019-0084. Epub 2019 Jun 5.

Abstract

Aim: This study aims to evaluate lumbar drainage (LD) for controlling refractory intracranial hypertension among non-HIV cryptococcal meningitis patients. Patients & methods: A case-control study was designed to compare LD (case) with repeated lumbar puncture (control). Results: Both LD and repeated lumbar puncture can efficiently control refractory intracranial hypertension. LD group showed better clinical symptom remission, such as lower rate of headache, vision disorders, signs of meningeal irritation and conscious disturbance, than control group. LD group was reported with higher intracranial pressure reduction (173.75 ± 17.72 mmH2O) than those among control group (113.50 ± 14.94 mmH2O; p < 0.05). Conclusion: LD is an effective and safe alternative to control refractory intracranial hypertension in HIV-negative cryptococcal meningitis patients.

Keywords: cryptococcal meningitis; lumbar drainage; lumbar puncture; refractory intracranial hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Drainage*
  • Female
  • Humans
  • Intracranial Hypertension / physiopathology
  • Intracranial Hypertension / therapy*
  • Male
  • Meningitis, Cryptococcal / physiopathology
  • Meningitis, Cryptococcal / therapy*
  • Middle Aged
  • Spinal Puncture*
  • Treatment Outcome