1.A meta-analysis on the use of acetazolamide in the management of elevated intracranial pressure in cases of cryptococcal meningitis.
Katherine Ann J SAN DIEGO ; Jennifer Justice F MANZANO ; Philip A RAMIRO
Philippine Journal of Neurology 2008;12(2):35-35
The incidence of CNS infection is common in developing countries such as ours, a common complication of which is elevated intraaanial pressure. The deleterious effects of increased ICP in may manifest as severe headache, visual impairment and mortality. Several modalities have been suggested for the management of ICP either medical or surgical. However, for developing countries surgical procedures is not always feasible in most clinical centers due to lack of facilities or experts and as such medical management of ICP becomes the primary mode of treatment. Acetazolamide is an inexpensive, widely available drug that in theory can lower elevated ICP. There are also some anecdotal evidence on its efficacy. This paper aims to assess the efficacy of using acetazolamide in the management of increased ICP. Intensive search of the online medical journals were done using the following keywords: "Acetazolamide", "intracranial pressure", "hydrocephalus", "acetazolamide and increased intraaanial pressure", "cryptococcal meningitis". Five citations were obtained and based on the set inclusion and exclusion criteria, two trials were deemed appropriate for this review. Critical appraisal was done which validated the trials. Overall, the two studies analyzed showed conflicting data regarding the use of acetazolamide in the management of inereased intracranial pressure. The data available from this meta-analysis shows little or no effect in giving acetazolamide for the treatment of increased ICP. This meta-analysis, however is based only on 2 RCTs with a total of 40 patients. There is still a need to conduct studies with bigger sample sizes to provide more conclusive evidence on the utility or non-utility ofacetazolamied in ICP.
Human ; Male ; Female ; Acetazolamide ; Intracranial Pressure ; Musculoskeletal And Neural Physiological Phenomena ; Nervous System Physiological Phenomena ; Cerebrospinal Fluid Pressure ; Hydrocephalus ; Nervous System Diseases ; Central Nervous System Diseases ; Brain Diseases ; Meningitis, Cryptococcal ; Bacterial Infections And Mycoses ; Mycoses ; Central Nervous System Fungal Infection ; Meningitis, Fungal ; Therapeutics ; Therapy ; Treatment Outcome
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