Bhagwati S N, George K
Childs Nerv Syst. 1986;2(1):20-5. doi: 10.1007/BF00274028.
A preliminary study to evaluate the efficacy of intrathecal hyaluronidase was carried out in nine children suffering from tuberculous meningitis with communicating hydrocephalus. This was followed by a randomized trial in which five cases were treated with intrathecal hyaluronidase, while six cases were treated by the insertion of a ventriculoperitoneal shunt. No untoward reaction of any significance was noted. The results were judged in terms of improvement in the sensorium and mentation, in specific neurological deficit (e.g., visual impairment and hemiparesis), and in overall functional performance. Although most of the patients receiving hyaluronidase showed some improvement in the sensorium, only one of the nine preliminary cases and one of the five cases in the randomized trial showed a total recovery of function. Two of the six shunted patients, however, showed complete recovery. Shunt insertion led to further improvement in two of the nine preliminary cases who had failed to respond to treatment with hyaluronidase. This preliminary study shows that intrathecal hyaluronidase does, in most cases, lead to an improvement in the sensorium but does not offer any particular advantage over shunt insertion in terms of regression of specific neurological deficit or overall functional improvement.
对9例患有交通性脑积水的结核性脑膜炎患儿进行了一项评估鞘内注射透明质酸酶疗效的初步研究。随后进行了一项随机试验，其中5例接受鞘内注射透明质酸酶治疗，6例接受脑室腹腔分流术治疗。未观察到任何显著的不良反应。结果根据意识和精神状态的改善、特定神经功能缺损（如视力损害和偏瘫）以及整体功能表现进行判断。虽然大多数接受透明质酸酶治疗的患者意识有所改善，但在初步研究的9例病例中只有1例、在随机试验的5例病例中只有1例功能完全恢复。然而，6例接受分流术的患者中有2例显示完全恢复。在9例对透明质酸酶治疗无反应的初步研究病例中，有2例在插入分流管后病情进一步改善。这项初步研究表明，在大多数情况下，鞘内注射透明质酸酶确实能改善意识，但在特定神经功能缺损的消退或整体功能改善方面，与插入分流管相比没有任何特别优势。
