Post-infective Hydrocephalus

  • Living reference work entry
  • First Online:
Pediatric Hydrocephalus

Abstract

Hydrocephalus which occurs after pyogenic or chronic infections of the brain is called “post-infective” hydrocephalus. Escherichia coli, group B streptococci, and Haemophilus and Neisseria meningitidis may be the causative organisms responsible for pyogenic meningitis in different age groups, and hydrocephalus follows the development of inflammatory exudates in the basal cisterns. In post-tubercular hydrocephalus, it is the fibrosis in the healing stage that is responsible for occlusion of the arachnoid villi and cerebrospinal fluid pathways. Hydrocephalus can also occur after prenatal infections like after toxoplasmosis or cytomegalovirus infections. Rarely hydrocephalus may occur after mycotic or viral infections of the brain. Whereas in post-infective hydrocephalus, the CSF is rendered sterile while a temporizing procedure like a ventriculo-subgaleal shunt may be performed, in the post-tubercular hydrocephalus, it is necessary to ascertain the level of intraventricular pressure before deciding on a diversion procedure, either by an endoscopic third ventriculostomy or a ventriculoperitoneal shunt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Similar content being viewed by others

References

  • al-Ali HY, Yasseen SA, Raof TY (1999) Follow-up of pregnant women with active cytomegalovirus infection. East Mediterr Health J 5(5):949–954

    PubMed  CAS  Google Scholar 

  • Alonso A, Alvarez A, Seara MJ, Linares M, Villalon J (1996) Unusual manifestations of postnatally acquired cytomegalovirus infection: findings on CT and MR. Pediatr Radiol 26(11):772–774

    Article  CAS  PubMed  Google Scholar 

  • Andreula CF, Burdi N, Carella A (1993) CNS cryptococcosis in AIDS: spectrum of MR findings. J Comput Assist Tomogr 17:438–441

    Article  CAS  PubMed  Google Scholar 

  • Arsura EL, Kilgore WB, Caldwell JW et al (1998) Association between facial cutaneous coccidioidomycosis and meningitis. West J Med 169:13–16

    PubMed  PubMed Central  CAS  Google Scholar 

  • Arumugasamy N (1985) Intracerebral cryptococcomas. Ann Acad Med Singap 14:16–21

    PubMed  CAS  Google Scholar 

  • Bale JF Jr, Reiley TT, Bray PF et al (1980) Cytomegalovirus and dual infection in infants. Arch Neurol 37(4):236–238

    Article  PubMed  Google Scholar 

  • Barkovich AJ, Girard N (2003) Fetal brain infections. Childs Nerv Syst 19:501–511

    Article  PubMed  Google Scholar 

  • Bouza E, Dreyer JS, Hewitt WL et al (1981) Coccidioidal meningitis: an analysis of 31 cases and review of literature. Medicine (Baltimore) 60(3):139–172

    Article  CAS  Google Scholar 

  • Bray PF, Bale JF, Anderson RE et al (1981) Progressive neurological disease associated with chronic cytomegalovirus infection. Ann Neurol 9(5):499–502

    Article  CAS  PubMed  Google Scholar 

  • Brogi E, Cibas ES (2000) Cytologic detection of Toxoplasma gondii tachyzoites in cerebrospinal fluid. Am I Clin Pathol 114:951–955

    Article  CAS  Google Scholar 

  • Cardia E, Molina D, Abbate F et al (1995) Morphological modifications of the choroid plexus in a rodent model of acute ventriculitis induced by gram-negative liquoral sepsis. Possible implications in the pathophysiology of hypersecretory hydrocephalus. Childs Nerv Syst 11(9):511–516

    Article  CAS  PubMed  Google Scholar 

  • Chen SC (2002) Cryptococcosis in Australasia and the treatment of cryptococcal and other fungal infections with liposomal amphotericin B. I Antimicrob Chemother 49(Suppl A):57–61

    Article  CAS  Google Scholar 

  • Cinalli G, Sainte-Rose C, Chumas P et al (1999) Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 90:448–454

    Article  CAS  PubMed  Google Scholar 

  • Cipri S, Gambardella G (2001) Neuroendoscopic approach to complex hydrocephalus. Personal experience and preliminary report. J Neurosurg Sci 45:92–96

    PubMed  CAS  Google Scholar 

  • Conly JM, Ronald AR (1983) Cerebrospinal fluid as a diagnostic body fluid. Am J Med 75(1B): 102–108

    Article  CAS  PubMed  Google Scholar 

  • Corti M, Priarone M, Negroni R et al (2014) Ventriculoperitoneal shunts for treating increased intracranial pressure in cryptococcal meningitis with or without ventriculomegaly. Rev Soc Bras Med Trop 47(4):524–527. PubMed PMID: 25229298

    Article  PubMed  Google Scholar 

  • Couvreur J, Desmonts G: Toxoplasmosis. Vinken PJ, Bruyn GW Handbook of clinical neurology, 35. North Holland, Amsterdam, 115–141, 1978

    Google Scholar 

  • Dastur DK, Manghani DK, Udani PM (1995) Pathology and pathogenetic mechanisms in neurotuberculosis. Radiol Clin N Am 33:733–752

    PubMed  CAS  Google Scholar 

  • Doctor BA, Newman N, Minich NM et al (2001) Clinical outcomes of neonatal meningitis in very-low birth-weight infant. Clin Pediatr (Phila) 40(9):473–480

    Article  CAS  Google Scholar 

  • Doherty RL, Jordan MC (1989) Viral meningoencephalitis. In: Hoeprich PD, Jordan MC (eds) Infectious diseases, 4th edn. Lippincott, Philadelphia, pp 1098–1108

    Google Scholar 

  • Erly WK, Bellon RJ, Seeger JF et al (1999) MR imaging of acute coccidioidal meningitis. AJNR Am J Neuroradiol 20:509–514

    PubMed  CAS  Google Scholar 

  • Falangola MF, Petito CK (1993) Choroid plexus infection in cerebral toxoplasmosis in AIDS patients. Neurology 43:2035–2040

    Article  CAS  PubMed  Google Scholar 

  • Fessler RD, Sobel J, Guyot L et al (1998) Management of elevated intracranial pressure in patients with cryptococcal meningitis. I Acquir Immune Defic Syndr Hum Retrovirol 17:137–142

    Article  CAS  Google Scholar 

  • Fishman RA (1992) Cerebrospinal fluid in diseases of the nervous system, 2nd edn. Saunders, Philadelphia

    Google Scholar 

  • Foulon W, Naessens A, Ho-Yen D (2000) Prevention of congenital toxoplasmosis. J Perinat Med 28(5):337–345

    Article  CAS  PubMed  Google Scholar 

  • Fries BC, Lee SC, Kennan R et al (2005) Phenotypic switching of Cryptococcus neoformans can produce variants that elicit increased intracranial pressure in a rat model of cryptococcal meningoencephalitis. Infect Immun 73:1779–1787

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fritsch M, Manwaring KH (1997) Endoscopic treatment of brain abscess in children. Minim Invasive Neurosurg 40(3):103–106. PubMed PMID: 9359089

    Article  CAS  PubMed  Google Scholar 

  • Fujita NK, Reynard M, Sapico FL et al (1981) Cryptococcal intracerebral mass lesions: the role of computed tomography and nonsurgical management. Ann Intern Med 94:382–388

    Article  CAS  PubMed  Google Scholar 

  • Gagne SS (2001) Toxoplasmosis. Prim Care Updat Ob Gyns 8(3):122–126

    Article  Google Scholar 

  • Galgiani IN, Peng T, Lewis ML et al (1996) Cerebrospinal fluid antibodies detected by ELISA against a 33-kDa antigen from spherules of Coccidioides immitis in patients with coccidioidal meningitis. The National Institute of Allergy and Infectious Diseases Mycoses Study Group. J Infect Dis 173:499–502

    Article  CAS  PubMed  Google Scholar 

  • Goel A (2004) Tuberculous meningitis and hydrocephalus. Neurol India 54(2):155

    Google Scholar 

  • Gomes I, Melo A, Lucena R et al (1996) Prognosis of bacterial meningitis in children. Arq Neuropsiquiatr 54(3):407–411

    Article  CAS  PubMed  Google Scholar 

  • Gumbo T, Kadzirange G, Mielke J et al (2002) Cryptococcus neoformans meningoencephalitis in African children with acquired immunodeficiency syndrome. Pediatr Infect Dis J 21:54–56

    Article  PubMed  Google Scholar 

  • Handler LC, Wright MG (1978) Postmeningitic hydrocephalus in infancy. Ventriculography with special reference to ventricular septa. Neuroradiology 16:31–35

    Article  CAS  PubMed  Google Scholar 

  • Hardesty DA, Ramey W, Afrasiabi M et al (2014) Patient outcomes and surgical complications in coccidioidomycosis-related hydrocephalus: an institutional review. J Neurosurg 121(4): 785–789. https://doi.org/10.3171/2014.6.JNS14111. Epub 2014 Jul 25. PubMed PMID: 25061867

    Article  PubMed  Google Scholar 

  • Hayward JC, Titelbaum DS, Clancy RR et al (1991) Lissencephaly-pacygyria associated with congenital cytomegalovirus infection. Child Neurol 6(2):109–114

    Article  CAS  Google Scholar 

  • Hospenthal DR, Bennett JE (2000) Persistence of cryptococcomas on neuroimaging. Clin Infect Dis 31:1303–1306

    Article  CAS  PubMed  Google Scholar 

  • Hower J, Clar HE, Duchting M (1972) Mumps as a cause of hydrocephalus. Pediatrics 50:346–347

    PubMed  CAS  Google Scholar 

  • Jellinger G (1986) Anatomopathology of nontumoral aqueductal stenosis. J Neurosurg Sci 30:1–16

    PubMed  CAS  Google Scholar 

  • Jha DK, Vineeta M, Ajay C et al (2007) Factors affecting the outcome of neuroendoscopy in patients with tuberculous meningitis hydrocephalus: a preliminary study. Surg Neurol 68(1): 35–41

    Article  PubMed  Google Scholar 

  • Jordan C (1989) In: Hoeprich PD, Jordan MC (eds) Infectious disease, 4th edn. JB Lippincott Company, Philadelphia/Grand Rapids/New York/St. Louis/San Francisco/London/Sydney/Tokyo, pp 805–811

    Google Scholar 

  • Kaiser G (1985) Hydrocephalus following toxoplasmosis. Z Kinderchir 40(Suppl 1):10–11

    PubMed  Google Scholar 

  • Knoper SR, Galgiani IN (1988) Systemic fungal infections: diagnosis and treatment. 1. Coccidioidomycosis. Infect Dis Clin N Am 2:861–875

    CAS  Google Scholar 

  • Lapierre J, Tourte-Schaefer C, Heyer F et al (1983) Congenital toxoplasmosis. Remarks apropos of serologic surveillance in 15,000 pregnant women. Sem Hop 59(40):2741–2745

    PubMed  CAS  Google Scholar 

  • Lee WS, Puthucheary SD, Omar A (1999) Salmonella meningitis and its complications in infants. J Paediatr Child Health 35(4):379–382

    Article  CAS  PubMed  Google Scholar 

  • Li L, Padi A, Ranjeva SL, Donaldson S et al (2011) Association of bacteria with hydrocephalus in Ugandan infants. J Neurosurg Paediatrics 7:73–87

    Article  Google Scholar 

  • Lorber J, Pickering D (1966) Incidence and treatment of post-meningitic hydrocephalus in the newborn. Arch Dis Child 41:44–50

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Luft BJ, Remington JS (1989) Toxoplasmosis. In: Hoeprich PD, Jordan MC (eds) Infectious disease, 4th edn. JB Lippincott Company, Philadelphia, pp 1199–1214

    Google Scholar 

  • Mahajan KR, Roberts AL, Curtis MT et al (2016) Diagnostic challenges of Cryptococcus neoformans in an immunocompetent individual masquerading as chronic hydrocephalus. Case Rep Neurol Med 2016:7381943. https://doi.org/10.1155/2016/7381943. Epub 2016 Jul 20

    Article  PubMed  PubMed Central  Google Scholar 

  • Manz HJ, Schuelein M, McCullough DC et al (1980) New phenotypic variant of adrenoleukodystrophy. Pathologic, ultrastructural, and biochemical study in two brothers. J Neurol Sci 45(2–3): 245–260

    Article  CAS  PubMed  Google Scholar 

  • Mathew JM, Rajsekhar V, Chandy MJ (1998) Shunt surgery in poor grade patients with tuberculous meningitis and hydrocephalus: effects of response to external ventricular drainage and other variables on long-term outcome. J Neurol Neurosurg Psychiatry 65:115–119

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Matsumoto N, Yano S, Miyao M et al (1983) Two-dimensional ultrasonography of the brain: its diagnostic usefullness in herpes simplex encephalitis and cytomegalic inclusion disease. Brain Dev 5(3):327–333

    Article  CAS  PubMed  Google Scholar 

  • Meenken C, Assies J, van Nieuwenhuizen O et al (1995) Long term ocular and neurological involvement in severe congenital toxoplasmosis. Br J OphthalmoI 79:581–584

    Article  CAS  Google Scholar 

  • Morgenlander JC (1994) Lumbar puncture and CSF examination. Postgrad Med 95(8):125–131

    Article  CAS  PubMed  Google Scholar 

  • Oi S, Abbott R (2004) Loculated ventricles and isolated compartments in hydrocephalus: their pathophysiology and the efficacy of neuroendoscopic surgery. Neurosurg Clin N Am 15:77–87

    Article  PubMed  Google Scholar 

  • Overturf GD (1989) Bacterial meningitis. In: Hoeprich PD, Jordan MC (eds) Infectious disease, 4th edn. JB Lippincott Company, Philadelphia/Grand Rapids/New York/St. Louis/San Francisco/London/Sydney/Tokyo, pp 1114–1132

    Google Scholar 

  • Palur R, Rajsekhar V, Chandy MJ et al (1991) Shunt surgery for hydrocephalus in tuberculous meningitis: a long term follow-up study. J Neurosurg 74:64–69

    Article  CAS  PubMed  Google Scholar 

  • Pappagianis D (1993) Coccidioidomycosis. Semin Dermatol 12:301–309

    PubMed  CAS  Google Scholar 

  • Park MK, Hospenthal DR, Bennett JE (1999) Treatment of hydrocephalus secondary to cryptococcal meningitis by use of shunting. Clin Infect Dis 28(3):629–633

    Article  CAS  PubMed  Google Scholar 

  • Parker KM, Nicholson JK, Cezayirli RC et al (1996) Aspergillosis of the sphenoid sinus: presentation as a pituitary mass and post-operative Gallium-67 imaging. Surg Neurol 45:354–358

    Article  CAS  PubMed  Google Scholar 

  • Perlman JM, Argyle C (1992) Lethal cytomegalovirus infection in preterm infants: clinical, radiological, and neuropathological findings. Ann Neurol 31(1):64–68

    Article  CAS  PubMed  Google Scholar 

  • Post MJ, Hensley GT, Moskowitz LB et al (1986) Cytomegalic inclusion virus encephalitis in patients with AIDS: CT, clinical, and pathologic correlation. AJR Am J Roentgenol 146(6):1229–1234

    Article  CAS  PubMed  Google Scholar 

  • Prats JM, Lopez-Heredia J, Gener B et al (2001) Multilocular hydrocephalus: ultrasound studies of origin and development. Pediatr Neurol 24(2):149–151

    Article  CAS  PubMed  Google Scholar 

  • Punt J (1993) Principles of CSF diversion and alternative treatments. In: Schurr PH, Polkey CE (eds) Hydrocephalus. Oxford Medical Publications, Oxford, pp 139–160

    Google Scholar 

  • Raheja H, Sinha A, Irukulla PK (2017) Cryptococcal meningitis masquerading as normal pressure hydrocephalus in an immunocompetent adult. J Glob Infect Dis 9(4):157–159

    Article  PubMed  PubMed Central  Google Scholar 

  • Romeo JH, Rice LB, McQuarrie IG (2000) Hydrocephalus in coccidioidal meningitis: case report and review of the literature. Neurosurgery 47:773–777

    PubMed  CAS  Google Scholar 

  • Rotilio A, Salar G, Dollo C et al (1985) Aqueductal stenosis following mumps infection. Case report. Ital J Neurol Sci 6:237–239

    Article  CAS  PubMed  Google Scholar 

  • Russell DS (1949) Observations on the pathology of hydrocephalus. Medical Res Council, special report series, vol 265. His Majesty’s Stationery Office, London

    Google Scholar 

  • Schoeman JF, Honey EM, Loock DB (1996) Raised ICP in a child with cryptococcal meningitis: CT evidence of a distal CSF block. Childs Nerv Syst 12:568–571

    Article  CAS  PubMed  Google Scholar 

  • Schultz P, Leeds NE (1973) Intraventricular septations complicating neonatal meningitis. J Neurosurg 38:620–626

    Article  CAS  PubMed  Google Scholar 

  • Seehusen DA, Reeves MM, Demitri F (2003) Cerebrospinal fluid analysis. Am Fam Physician 8(6):1103–1108

    Google Scholar 

  • Senat MV, Bernard JP, Schwarzler P et al (1999) Prenatal diagnosis and follow-up of 14 cases of unilateral ventriculomegaly. Ultrasound Obstet GynecoI 14:327–332

    Article  CAS  Google Scholar 

  • Sharma R, Bahl L, Goyal A et al (1995) Congenital cytomegalovirus infection in Shimla Hills, Himachal Pradesh. India J Commun Dis 27:23–26

    PubMed  CAS  Google Scholar 

  • Sil K, Chatterjee S (2008) Shunting in tuberculous meningitis: a surgeon’s nightmare. Childs Nerv Syst 24(9):1029–1032

    Article  PubMed  Google Scholar 

  • Stahl W, Kaneda Y (1997) Pathogenesis of murine toxoplasmic hydrocephalus. Parasitology 114(Pt 3):219–229

    Article  PubMed  Google Scholar 

  • Stoll BJ, Schuchat A (1998) Maternal carriage of group B streptococci in develo** countries. Padiatr Infect Dis J 17:499–503

    Article  CAS  Google Scholar 

  • Takano T, Mekata Y, Yamano T et al (1993) Early ependymal changes in experimental hydrocephalus after mumps virus inoculation in hamsters. Acta Neuropathol (Berl) 85:521–525

    Article  CAS  Google Scholar 

  • Thwaites G, Chau TTH, Mai NTH et al (2000) Tuberculous meningitis. J Neurol Neurosurg Psychiatry 68:289–299

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Udani V, Udani S, Merani R et al (2003) Unrecognized ventriculitis/meningitis presenting as hydrocephalus in infancy. Indian Pediatr 40(9):870–873

    PubMed  Google Scholar 

  • van Landegem FK, Stiller B, Lehmann TN et al (2000) Aqueductal stenosis and hydrocephalus in an infant due to aspergillus infection. Clin Neuropathol 19:26–29

    Google Scholar 

  • Warf BC (2005) Hydrocephalus in Uganda: the predominance of infectious origin and primary management with endoscopic third ventriculostomy. J Neurosurg 102(1):1–15

    Article  PubMed  Google Scholar 

  • WHO Young Infants Sudy Group (1999) Bacterial etiology of serious infections in young infants in develo** countries: results of a multicentre study. Paediatr Infect Dis 18(10 suppl):S17–S22

    Google Scholar 

  • Wolinsky JS (1977) Mumps virus-induced hydrocephalus in hamsters. Ultrastructure of the chronic infection. Lab Investig 37:229–236

    PubMed  CAS  Google Scholar 

  • Wrobel Q, Meyer S, Johnson RH et al (1992) MR findings in acute and chronic coccidioidomycosis meningitis. AJNR Am J NeuroradioI 13:1241–1245

    CAS  Google Scholar 

  • **e D, Cao H, Yu H (1999) Differential diagnosis in patients with tuberculous meningitis and cryptococcal meningitis [in Chinese]. Zhonghua Jie He He Hu ** Za Zhi 22:731–733

    PubMed  CAS  Google Scholar 

  • Yaramis A, Gurkan F, Elevli M et al (1998) Central nervous system tuberculosis in children: a review of 214 cases. Paediatrics 102:e49

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sandip Chatterjee .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Chatterjee, S. (2018). Post-infective Hydrocephalus. In: Cinalli, G., Ozek, M., Sainte-Rose, C. (eds) Pediatric Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-31889-9_58-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31889-9_58-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31889-9

  • Online ISBN: 978-3-319-31889-9

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Navigation