Management of Infected Hydrocephalus in Infancy; Repeated Tapping versus External Ventricular Drain

Abstract

Background: Infected hydrocephalus is are the most frequent consequences in ventriculoperitoneal shunt patient. Most of the patient treated by external ventricular drain under antibiotic cover. Aim of study: To assess the advantage of ventricular tap compared to external ventricular drain in treating infected hydrocephalus patients in infancy. Patient and methods: A clinical prospective study of 40 patients with infected hydrocephalus collected over one and a half year (2015-2016) in Al-Shahid Ghazi Al-Hariri hospital, medical city, Baghdad. After thorough general and neurological examination, patent was divided in two groups. One treated by external ventricular drain and the other treated by ventricular tap. Both groups were under antibiotic cover. Results: The male: female ratio is1.7, the age’s mean of the study group is 90.4 days. The most frequent cause of hydrocephalus in the study group is congenital hydrocephalus 62.5%. Post meningitis is 32.5% .IVH is 5% .37.5% is associated with myelomeningeocele as associated congenital anomalies. Clear CSF was found in 15% EVD patients, and 89% in ventricular tap patients. The mortality rate is 5% in the EVD, with no death in the ventricular tap patients. Conclusion: Ventricular tap is better in treating patient with infected hydrocephalus than external ventricular drain. EVD group require longer hospital stay along with longer antibiotic cover with lower cure rate and higher mortality compared to the ventricular tap.