Images in clinical medicine | Volume 36, Article 209, 23 Jul 2020 | 10.11604/pamj.2020.36.209.21342

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

Hilal Abboud, Abdessamad Elouahabi

Corresponding author: Hilal Abboud, Department of Neurosurgery, Spécialités ONO hospital, Mohamed V University, Rabat, Morocco

Received: 17 Dec 2019 - Accepted: 13 Jul 2020 - Published: 23 Jul 2020

Domain: Headache Medicine,Neuroradiology,Neurosurgery

Keywords: Calcification, unusual evolution, partitioned hydrocephalus, tuberculous meningitis

©Hilal Abboud et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Hilal Abboud et al. An unusual evolution of a partitioned post tubercular meningitic hydrocephalus. Pan African Medical Journal. 2020;36:209. [doi: 10.11604/pamj.2020.36.209.21342]

Available online at: https://www.panafrican-med-journal.com/content/article/36/209/full

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Images in clinical medicine

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

Hilal Abboud1,&, Abdessamad Elouahabi1

 

1Department of Neurosurgery, Spécialités ONO hospital, Mohamed V University, Rabat, Morocco

 

 

&Corresponding author
Hilal Abboud, Department of Neurosurgery, Spécialités ONO hospital, Mohamed V University, Rabat, Morocco

 

 

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Post meningitic hydrocephalus occurs in 20 to 70% of bacterial or BK meningitis in infants and are responsible for a severe neuropsychic sequelae, the compartmentalized forms are seen in less than 2% of cases, and can pose therapeutic difficulties for drainage of large or multiple partitions. Calcification, rather a mode of involution of the fleshy lesions, is an unusual evolutionary mode of partitioned hydrocephalus. We report the case of a 26 years old man, treated at the age of six months for compartmentalized hydrocephalus on tuberculous meningitis with a good outcome under VPS. Recent cerebral MRI and CT scan (A,B,C and D) after an epileptic episode found a sequellar ventriculomegaly in iddition to an intracerebral, right occipital, cystic formation with complete calcification of the wall, revealing an exceptional evolutionary mode of compartmentalized hydrocephalus. Given the good control of epilepsy under medical treatment, the surgical indication was not retained.

 

 

Figure 1: A) FLAIR- weighted cerebral MRI on axial sequences: a sequellar ventriculomegaly without signs of transependymal resorption, in addition to an intracerebral, right occipital, oval formation with a complete calcification of the wall; B) T2- weighted cerebral MRI on axial sequences: the oval formation seems to be extra axial with a fluid density, but different from the CSF signal; C) Cerebral CT scan on parenchyma window and sagittal sequences: Despite the large volume of the oval formation, there is no perilesional edema, in favour of the age of evolution; D) Cerebral CT scan on parenchyma window and axial sequences: a bone bulge adjacent to the calcified cyst. The proximal tip of the catheter of VPS Shunt is seen near the cyst

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

Images in clinical medicine

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

Images in clinical medicine

An unusual evolution of a partitioned post tubercular meningitic hydrocephalus