Jian lin, hui zhou, nu zhang, bo yin, & hang-song sheng.Effects of the implantation of ommaya reservoir in children with tuberculous meningitis hydrocephalus: a preliminary study.Child's nervous system 28 (2012).Doi 10.1007/s00381-012-1748-2.Abstract objective the role of ommaya reservoir implantation in children with tuberculous meningitis hydrocephalus (tbmh) has been seldomly reported.Therefore, we performed this study to determine the role of the ommaya reservoir in the treatment of children with tbmh.Methods we retrospectively analyzed the effects of ommaya reservoir implantation in 12 children with tbmh.Intracapsular puncture of the reservoir was performed for draining the cerebrospinal fluid and the tbm was treated by intraventricular injection of isoniazid.Results the ideal treatment outcome was observed in nine (75 %) of the 12 children; two (16.7 %) children developed serious disabilities and one of them (8.3 %) eventually died.The treatment method was effective for all six (100 %) children with palur grade ii tbm but showed no effect in three (50 %) children with grade iii and iv tbm.The number of leukocytes in the cerebrospinal fluid decreased to 20×106/l (75 %) within 2 weeks after implantation of the reservoirs.Finally, the ommaya reservoirs in eight children were removed but were retained in four children.Four children had to undergo ventriculoperitoneal shunt.Conclusion ommaya reservoir implantation has been shown to be effective in treating children with tbmh.This method may be largely suitable for children with early grade ii tbm or partly in children with grade iii tbm who have mild or moderate hydrocephalus that can alleviate after short-term treatment.Thus, a good proportion of children who undergo ommaya reservoir implantation can avoid ventriculoperitoneal shunt surgery.Reported events.1.A 6 year old female was implanted with an ommaya reservoir due to communicating tbmh.The reservoir became clogged and had to be washed with saline for proper functioning.The ommaya reservoir was not removed; however, due to the patient showing insufficient improvement in their clinical symptoms, a vp shunt surgery was performed.The patient's outcome was satisfactory.2.A 11 year old female was implanted with an ommaya reservoir due to communicating tbmh.The patient experienced an intraventricular hemorrhage after surgical removal of the reservoir but showed good recovery after conservative treatment.The patient's outcome was satisfactory.3.A 11 year old male was implanted with an ommaya reservoir due to noncommunicating tbmh.The patient showed a slight effusion around the reservoir under the scalp, which stopped after csf extraction and wound compression.The ommaya reservoir was removed, and the patient's outcome was satisfactory.
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