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Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis
Thesis (MMed)--Stellenbosch University, 2024.
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867614040716476416 |
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| access_status_str | Open Access |
| author | Tembo, Jonatha Felix |
| author2 | Gretschel, Armin |
| author_browse | Gretschel, Armin Tembo, Jonatha Felix |
| author_facet | Gretschel, Armin Tembo, Jonatha Felix |
| author_sort | Tembo, Jonatha Felix |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description |
Thesis (MMed)--Stellenbosch University, 2024. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/131927 |
| institution | Stellenbosch University (South Africa) |
| last_indexed | 2026-06-10T12:45:43.568Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/131927 Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis Tembo, Jonatha Felix Gretschel, Armin Vlok, Adriaan Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Surgical Sciences. Division of Neurosurgery. Hydrocephalus in children -- South Africa Meninges -- Tuberculosis -- South Africa Children -- Diseases -- Diagnosis -- South Africa Brain -- Imaging -- South Africa UCTD Thesis (MMed)--Stellenbosch University, 2024. ENGLISH ABSTRACT: Background: Tuberculosis (TB) infection occurs in 2 billion people globally with up to 20% of TB-related deaths occurring in children. Central nervous system TB is rare, and hydrocephalus (HCP) is a common complication. Tuberculous meningitis (TBM) HCP can be communicating, or non-communicating and the type influences the management. Currently air-encephalogram is the gold standard to distinguish between the types. Previous studies have unsuccessfully evaluated computed tomography (CT) brain features to differentiate between the two. However, none of these assessed the Sylvian fissure size to determine hydrocephalus type (HT). Methods: Data were retrospectively reviewed and prospectively collected. Patients with TBM HCP between the ages 6 months to 14 years were included. Air-encephalogram determined the HT of 60 patients (30 communicating, 30 non-communicating). Blinded to air-encephalogram results, a neurosurgeon, paediatric neurologist and radiologist reviewed the patients’ CT-brain in random order, twice weeks apart, using Sylvian fissure size to determine HT. Intra- and inter-reviewer accuracy was reviewed. Results: Accuracy in HT at initial assessment and 4 weeks was 53.3% and 53.3% for the neurosurgeon, 56.7% and 63.3% for paediatric neurologist and 58.3% and 50.0% for the radiologist. Using the Sylvian fissure size to differentiate between the HCP types appeared random with low inter- and intra-observer reliability. Conclusion: There is no reliable CT-brain feature that can accurately determine the HT in TBM. Air-encephalography remains the gold standard and despite it’s known complications, it remains a useful investigation to guide the management of TBM HCP. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2025-04-29T06:56:25Z 2025-04-29T06:56:25Z 2024-12 Thesis https://scholar.sun.ac.za/handle/10019.1/131927 Stellenbosch University v, 20 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Hydrocephalus in children -- South Africa Meninges -- Tuberculosis -- South Africa Children -- Diseases -- Diagnosis -- South Africa Brain -- Imaging -- South Africa UCTD Tembo, Jonatha Felix Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title | Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title_full | Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title_fullStr | Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title_full_unstemmed | Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title_short | Sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| title_sort | sylvian fissure size as a predictor of hydrocephalus type in paediatric tuberculous meningitis |
| topic | Hydrocephalus in children -- South Africa Meninges -- Tuberculosis -- South Africa Children -- Diseases -- Diagnosis -- South Africa Brain -- Imaging -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/131927 |
| work_keys_str_mv | AT tembojonathafelix sylvianfissuresizeasapredictorofhydrocephalustypeinpaediatrictuberculousmeningitis |