Our experience of ventriculoatrial shunt using Upadhyaya valve in cases of hydrocephalus associated with tuberculous meningitis.

A small series of nine cases of tuberculous meningitis with hydrocephalus is presented in which a ventriculoatrial shunt was carried out. Upadhyaya valves were used. Four of these nine cases are doing well and are normal 1 1/2 to 2 years after surgery. Two of them remained spastic and athetotic and died within 15 months and 18 months after surgery. One child, who had recovered fully, died 2 1/2 months after surgery from an intercurrent infection. Another patient, though fully recovered, died on the 27th day after surgery. One child (case 9) did not show any improvement after surgery and died 1 2/2 months to 3 months after surgery. The Upadhyaya valve is an excellent device for treating hydrocephalus. The operation itself has been successful in all cases and there were no complications attributable to the Upadhyaya valve in this series. Sixty-five to seventy percent of cases of tuberculous meningitis in children fall in groups III, IV and V of the classification of neurological deficit, and hydrocephalus is a constant accompaniment of these cases. It is, therefore, advisable to insert a VA shunt using the Upadhyaya valve at a very early stage and in all cases that fall in groups III, IV and V of neurological deficit.