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| Format: | Recurso digital |
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Zenodo
2025
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| Online Access: | https://doi.org/10.5281/zenodo.14876924 |
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Table of Contents:
- <p>We report a case of complicated tuberculous meningitis (TBM) combined with secondary tuberculous hydrocephalus, multiple tuberculoma and meningeal enhancement in sellar cistern, annular pool, high cervical pulp and thoracic pulp. The patient developed an intracranial hematoma due to multiple ventricular punctures during treatment at another hospital. After being transferred to our hospital, we performed long-time external ventricular drainage through abdominal subcutaneous tunnel combined with injections of anti-tuberculosis drugs into the cerebrospinal fluid (CSF). This treatment led to a rapid clearance of tuberculosis in the CSF and a return to normal CSF composition, facilitating the ventriculoperitoneal (VP) shunt operation. However, during the systemic anti-tuberculosis treatment after the operation, the patient developed progressive growth of lesions in the upper cervical and thoracic spinal cord, leading to high paraplegia and early respiratory failure. The surgical removal of these lesions and the application of local anti-tuberculosis drugs greatly improved the symptoms. After 11 months of follow-up, there was no recurrence of the lesion and the patient's neurological function recovered well. This case demonstrates the benefits of long-time external ventricular drainage through abdominal subcutaneous tunnel in treating TBM with secondary hydrocephalus, as well as the importance of l local anti-tuberculosis drugs usage. </p>