TRANSCRANIAL DOPPLER ULTRASONOGRAPHY IN HYDROCEPHALIC CHILDREN WITH TUBERCULOUS MENINGITIS

Studies have shown a close correlation between congenital hydrocephalu s (CH) and the Gosling pulsatility index (PI) determined by transcrani al Doppler ultrasonography (TCD). There have not previously been simil ar studies in children with hydrocephalus from tuberculous meningitis (TBM), and in particular where arteritis is a prominent feature. Fifte en children from each of these two groups were prospectively examined by TCD before and after CSF diversion. Fifteen children without hydroc ephalus were similarly evaluated as controls. The fall in PI following surgery was compared. The mean fall in PI in the congenital hydroceph alic group was 0.723 (SD, 0.42) as compared with 0.089 (SD, 0.16) in t he TBM group (p = 0.0001). Ten of the 15 children in the TBM group had infarcts revealed by CT. In these, the PI differed significantly post operatively (p = 0.004), (0.014; SD, 0.12) when compared with values o btained (0.24; SD, 0.11) in five children without infarcts. These find ings indicate that the clinically relevant fall in PI following CSF di version in children with congenital hydrocephalus does not necessarily occur in children with hydrocephalus secondary to TBM, especially whe n complicated by cerebral infarcts.