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Hydrocephalus Because of TB Meningitis

Hydrocephalus Because of TB Meningitis

Hydrocephalus is a common complication of tuberculosis meningitis (TB meningitis). If there is a delay in diagnosis, the patient can be rendered severely disabled.

What is TB meningitis?

TB meningitis is when the membranes around the brain and spinal cord (called the meninges) become infected with the tuberculosis bacteria.

What is hydrocephalus?

Hydrocephalus is when cerebrospinal fluid (CSF) builds up on the brain. The increased pressure damages the brain, potentially causing long-term damage.

TB meningitis and hydrocephalus

TB meningitis can lead to hydrocephalus. This is called acquired hydrocephalus, which is often a symptom of another underlying condition.

In a healthy person, the body creates around a pint of new CSF every day and the old CSF is drained away by the blood vessels. Illnesses such as TB meningitis hinder this process, causing CSF to build-up in the brain.

Diagnosing TB meningitis and hydrocephalus

TB meningitis will cause fever, tiredness, weight loss, headache and vomiting. As the condition progresses, the patient will begin to suffer neurological symptoms such as confusion and a loss of consciousness.

A patient who presents with these symptoms must undergo a variety of tests, specifically including a lumbar puncture and a brain scan.

A lumbar puncture will reveal a high white blood cell count, a low glucose score and high levels of protein. All of these clinical indicators are suggestive of a bacterial meningitis.

If the condition has progressed to a certain stage, an MRI scan of the brain will show dilated ventricles. In a clinical context, this represents hydrocephalus.

Hydrocephalus is present in 72% of patients with TB, but is rarely seen in conditions such as viral meningitis. Thus the presence of hydrocephalus should prompt the radiologist to use produce contrast images, and this will show the enhancement of the meninges. Such enhancement virtually only occurs in chronic infective meningitis including TB meningitis.

Delayed diagnosis of TB meningitis

If TB meningitis is not diagnosed and treated quickly enough, the raised intracranial pressure due to hydrocephalus will impair the blood flow to the brain, depriving the area of oxygen (ischaemia). This will result in a wider area of brain damage than would have occurred if the condition had been treated earlier.

If the delay in treatment happens because doctors fail to realise that the patient's test results indicate TB meningitis, there could be a case of medical negligence. Hydrocephalus is a common cause of TB meningitis, more so than other types of bacteria or viral illnesses.

Therefore the presence of dilated ventricles should lead doctors to consider the diagnosis of TB meningitis. This would also be in keeping with the lumbar puncture results showing increased white blood cells, increased protein and reduced glucose.

Speak to an expert

A failure to correctly diagnose hydrocephalus can make a material contribution to the delayed diagnosis of TB meningitis. Had the correct diagnosis been made, it would have led doctors to suspect TB meningitis and the patient would have been started on anti-TB therapy.

The earlier TB meningitis is diagnosed and treated, the better the outcome. A delay in treatment can severely injure the patient, resulting in widespread neurological damage.

If you or your loved one has suffered because medical practitioners failed to diagnose and treat TB meningitis in time, please get in touch with us at Glynns Solicitors.

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