An unusual evolution of a partitioned post tubercular meningitic hydrocephalus

Abstract

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 magnetic resonance imaging (MRI) and computed tomography (CT) scan (A,B,C and D) after an epileptic episode found a sequellar ventriculomegaly in addition 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.