1. Lumbar drainage for control of raised cerebrospinal fluid pressure in cryptococcal meningitis: case report and review
- Author
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Tihana Bicanic, Thomas S. Harrison, Henry Marsh, Derek C. Macallan, Karen F. Macsween, and Annemarie E. Brouwer
- Subjects
Adult ,Microbiology (medical) ,medicine.medical_specialty ,Antifungal Agents ,CSF PRESSURE ,Flucytosine ,Meningitis, Cryptococcal ,Spinal Puncture ,Raised intracranial pressure ,Lumbar ,Cerebrospinal Fluid Pressure ,Amphotericin B ,medicine ,Raised cerebrospinal fluid pressure ,Humans ,Fluconazole ,AIDS-Related Opportunistic Infections ,business.industry ,Ventricular dilatation ,medicine.disease ,Surgery ,Drug Combinations ,Treatment Outcome ,Infectious Diseases ,Anesthesia ,Cryptococcus neoformans ,HIV-1 ,Drainage ,Female ,Cerebrospinal fluid pressure ,Cryptococcal meningitis ,business ,Meningitis ,Deoxycholic Acid - Abstract
Raised intracranial pressure in the absence of ventricular dilatation is common in cryptococcal meningitis and associated with increased mortality. We report the case of a patient with HIV-associated cryptococcal meningitis, who developed increasing CSF pressure and visual impairment on therapy despite serial lumbar punctures. Insertion of a temporary lumbar drain controlled the opening pressure and resulted in full visual recovery. The advantages and necessary precautions with this approach are reviewed, and alternative protocols for the use of lumbar drains discussed.
- Published
- 2005
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