Lumbar drainage for the treatment of refractory intracranial hypertension in HIV-negative cryptococcal meningitis

• Published in: Future microbiology 2019-07, Vol.14 (10), p.859-866
• Main Authors: Zhang, Qilong, Li, Hang, Zhang, Keming, Arastehfar, Amir, Daneshnia, Farnaz, Fang, Wenjie, He, Peijuan, Kuang, Weifeng, Jiang, Guoqiang, Chen, Min, Boekhout, Teun, Li, Shuai, Jiang, Weiwei, Liao, Wanqing, Pan, Weihua
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Case-Control Studies; Clinical medicine; cryptococcal meningitis; Disease prevention; Drainage; Female; Headache; HIV; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Infections; Infectious diseases; Intracranial Hypertension - physiopathology; Intracranial Hypertension - therapy; Irritation; lumbar drainage; lumbar puncture; Male; Medical prognosis; Meningitis; Meningitis, Cryptococcal - physiopathology; Meningitis, Cryptococcal - therapy; Middle Aged; Patients; refractory intracranial hypertension; Remission; Review boards; Spinal Puncture; Treatment Outcome
• ISSN: 1746-0913; 1746-0921
• DOI: 10.2217/fmb-2019-0084

This study aims to evaluate lumbar drainage (LD) for controlling refractory intracranial hypertension among non-HIV cryptococcal meningitis patients. A case–control study was designed to compare LD (case) with repeated lumbar puncture (control). Both LD and repeated lumbar puncture can efficiently control refractory intracranial hypertension. LD group showed better clinical symptom remission, such as lower rate of headache, vision disorders, signs of meningeal irritation and conscious disturbance, than control group. LD group was reported with higher intracranial pressure reduction (173.75 ± 17.72 mmH O) than those among control group (113.50 ± 14.94 mmH O; p