Pathology

Tuberculosis

Surgery

Intensive care medicine

Neurointensive care

Tuberculous meningitis

Hydrocephalus

Intracranial pressure

Meningitis

Medicine

The Lancet Neurology

Tuberculous meningitis is the most severe form of tuberculosis and often causes critical illness with high mortality. Two primary management objectives are reducing intracranial pressure, and optimising cerebral perfusion, while killing the bacteria and controlling intracerebral inflammation. However, the evidence base guiding the care of critically ill patients with tuberculous meningitis is poor and many patients do not have access to neurocritical care units. Invasive intracranial pressure monitoring is often unavailable and although new non-invasive monitoring techniques show promise, further evidence for their use is required.

The neurocritical care of tuberculous meningitis