Management

• Elevate head and body by 30 degrees to optimize venous drainage

• Reduce fever and control hyperglycemia• Maintain osmolarity at 305-315 mOsm/L• Prevent seizures

• Specific measures include:– Hyperventilation– Mannitol • 1-2g/kg for severely increased pressure, followed by

50-300mg/kg q6

– Corticosteroid– Ventricular drainage– Primary disorder should be treated

General approach on brain tumors:

• Craniotomy• Stereotactic techniques• Radiosurgery• Shunts

Management of Meningitis

• Fungal meningititis: – long course of high dose antifungals, such as

amphotericin B and flucytosine• TB meningitis:– Isoniazid, rifampicin, pyrazinamide and

ethambutol for 2 months, followed by isoniazid anf rifampicin alone for a further ten months

– Steroids are always used in the first six weeks of treatment