Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Neurol India. 2021 Nov-Dec;69(Supplement):S320-S329. doi: 10.4103/0028-3886.332273.
Post-infective hydrocephalus (PIH) arises as a complication of any CNS infection, and can be either communicating or noncommunicating.
The aim of this article is to study the various causes of PIH and its pathophysiology and treatment.
The literature was searched for articles describing the causes of PIH.
Common causes of PIH are CNS tuberculosis (TB), neurocysticercosis, and perinatal or neonatal infection. TBM is most likely to result in hydrocephalus out of all these manifestations of CNS TB, and hydrocephalus is more likely to occur early in the course, typically 4-6 weeks after the onset of TBM, and is more common among children as compared to adults. A trial of medical management (antitubercular therapy, steroids, and decongestants) can be given to patients with communicating hydrocephalus. Ventriculoperitoneal shunt is the most employed method of CSF diversion in these patients. Though traditionally considered contraindicated, many recent studies have found ETV to be a reasonable option in patients with PIH. HCP in patients with neurocysticercosis can be associated with intraventricular cysts and racemose cysts in the basal subarachnoid cisterns. Surgical intervention is required either for cyst removal or CSF diversion. Endoscopic approaches can be used to remove the intraventricular cysts, which takes care of the HCP. PIH in infants can result either from antenatal infections (TORCH infections) or postnatal infections such as meningitis.
Management of PIH can be challenging. Management has to be individualized.
感染后脑积水（PIH）是中枢神经系统（CNS）感染的并发症，可表现为交通性或非交通性脑积水。
本文旨在研究 PIH 的各种病因及其病理生理学和治疗方法。
检索描述 PIH 病因的文献。
PIH 的常见病因包括中枢神经系统结核（TBM）、脑囊虫病和围产期或新生儿感染。在所有这些中枢神经系统 TB 的表现中，TBM 最有可能导致脑积水，并且脑积水更可能在病程早期发生，通常在 TBM 发病后 4-6 周，在儿童中比在成人中更常见。对于交通性脑积水患者，可以尝试进行药物治疗（抗结核治疗、类固醇和利尿剂）。脑室-腹腔分流术是这些患者中最常用的脑脊液分流方法。尽管传统上认为脑室-腹腔分流术是禁忌证，但许多最近的研究发现，对于 PIH 患者，它是一种合理的选择。神经囊虫病患者的 HCP 可伴有脑室囊肿和基底蛛网膜下腔脑回状囊肿。需要手术干预来去除囊肿或进行脑脊液分流。内镜方法可用于去除脑室囊肿，从而解决 HCP 问题。婴儿的 PIH 可由产前感染（TORCH 感染）或产后感染如脑膜炎引起。
PIH 的治疗具有挑战性，必须个体化。
