Neurosurgical Methods in the Treatment of Tuberculous Meningitis: With a Note on Some Unusual Manifestations of the Disease

The place of neurosurgical methods in the The method is to explore both lateral ventricles management of tuberculous meningitis has not yet through cranial burr-holes. When there is an been clearly defined. In Oxford, since our first abscess in one cerebral hemisphere the corresponding therapeutic intrathecal trials of penicillin in 1943, lateral ventricle tends to become obliterated and neurosurgical methods have been freely used in the ventricular system is displaced towards the many varieties of meningitis, and in this paper I opposite side. In meningitis, on the other hand, the shall describe them and try to assess their value in lateral ventricles are symmetrically placed and equal tuberculous meningitis. Under the term ' neuro-in size; in tuberculous meningitis they are usually surgical methods 'I include all operative procedures, already slightly dilated by the time the patient is such as cranial exploration by burr-holes or admitted to hospital, and from each of them 10, craniotomy, which are not normally employed by 15, or more ml. of cerebrospinal fluid can be the physician. obtained. Such a finding virtually excludes the presence of an abscess or massive tuberculoma in Ventricular Estimation and Ventriculography for one cerebral hemisphere.* Diagnosis