Hydrocephalus secondary to cysticercotic arachnoiditis. A long-term follow-up review of 92 cases.

Ninety-two patients with hydrocephalus secondary to cysticercotic meningitis were followed for a mean period of 8 years 11 months. The mortality rate was 50%, with most patients dying within the first 2 years after cerebrospinal fluid (CSF) shunting. The prognosis was worse in females than in males. Multiple surgical procedures for shunt obstruction were necessary in half of the patients. Complications such as bacterial meningitis and shunt obstruction were more frequent in the patients who died than in those who survived. The follow-up data revealed that the clinical status was satisfactory in 78% of survivors and unsatisfactory in 22%. Spontaneous remission of the cysticercotic arachnoiditis, as shown by the CSF findings, occurred in only 18% of the cases. In most patients, arachnoiditis and positive immune reactions persisted unchanged even after several years. The results demonstrate the poor outcome of these patients and indicate the need for better medical and surgical therapy.