Meningitis and Neurosurgical Treatment an Update

Meningitis and ventriculitis, serious infections causing inflammation of the protective membranes of the brain and spinal cord, pose significant challenges in neurosurgical practice. The management of these conditions often requires interventions beyond antibiotic administration and supportive care. We discuss the role of external ventricular drainage (EVD), a neurosurgical technique used for cerebrospinal fluid drainage, in managing these infections and other neurosurgical techniques for treating these infections. The EVD is particularly beneficial in controlling elevated intracranial pressure, a complication of these infections, and facilitating the administration of intrathecal antibiotics. Moreover, EVD presents a method for the procurement of cerebrospinal fluid samples for microbiological examination. Notwithstanding the potential perils and difficulties linked with EVD, including infection, hemorrhaging, catheter misplacement, and cerebrospinal fluid seepage, its employment can avert grave neurological sequelae in patients grappling with meningitis and ventriculitis. The intrathecal delivery of antibacterial agents, for instance, ampicillin, ceftazidime, ceftriaxone, gentamicin, meropenem, and vancomycin, has demonstrated efficacy in managing these disorders. The current manuscript emphasizes the imperative for judicious choice and observation of antibiotic utilization, predicated on the root cause of infection and patient-centric clinical determinants.