Efficacy of ventriculoperitoneal shunting in patients with cryptococcal meningitis with intracranial hypertension

Abstract

Background: Ventriculoperitoneal (VP) shunting in cryptococcal meningitis (CM) patients with high intracranial pressure (ICP) has been studied extensively.

Methods: A total of 74 CM patients with ICP were identified, including 27 patients with or without ventriculomegaly receiving VP shunting.

Results: Through retrospective analysis, there was an obvious decline in ICP as well as Cryptococcus count after VP shunting. Damage to the cranial nerves was improved after the surgery. For those patients receiving VP shunting, there was an obvious decline in ICP as well as Cryptococcus count, with less usage of mannitol. Hydrocephalus or ventriculomegaly was improved, and both the clearance time of Cryptococcus and the hospitalization time were shortened (p<0.05). The complications of VP shunting were not common.

Conclusions: For patients diagnosed with CM and with apparent ICP, VP shunting can be considered regardless of whether there is damage to the cranial nerves or hydrocephaly.

Keywords: Cryptococcal meningitis; Cryptococcus count; Intracranial pressure; Ventriculomegaly; Ventriculoperitoneal shunting.