Surgery for XXXX : a review.

@entity1 @entity6551 @entity1276 @entity75 @entity693 @entity1906 @entity378
UNASSIGNED: The two main manifestations of @entity378 that require surgery are @entity1276 associated with @entity1906 (TBMH) and @entity75 . TBMH most often responds to medical therapy but surgery is required promptly for those who fail medical therapy. Both ventriculoperitoneal (VP) shunt and endoscopic third ventriculostomy (ETV) are valid options although the latter is more often successful in @entity1 with chronic @entity1276 than in those with acute @entity693 . @entity1 with TBMH are more prone to complications following VP shunt than other @entity1 . The outcome of these @entity1 is determined by the Vellore grade (I to IV) of the @entity1 prior to surgery with those in good grades (I and II) having a better outcome and those in the worst grade (IV) having a high mortality in excess of 80  %. @entity1 with @entity75 present clinically with features of a @entity75 , indistinguishable clinically from other pathologies. CT and MR features might provide a probable diagnosis of a @entity6551 but most often a histological diagnosis is desirable. Empiric medical therapy is reserved for a small number of @entity1 . Although the treatment of @entity75 is essentially medical, surgery is required when the diagnosis is in doubt, to reduce raised intracranial pressure or local mass effect and to obtain tissue for culture and sensitivity studies. Stereotactic biopsy, stereotactic craniotomy and excision of superficial small @entity6551 and microsurgery are all procedures used to manage @entity75 . The outcome in @entity1 with @entity75 is good if the tuberculous bacillus is sensitive to the anti-tuberculous therapy. The duration of therapy is debated but we suggest at least 18  months of combination therapy with three or four anti-tuberculous drugs and continue the therapy till the @entity6551 has resolved on neuro-imaging.
