The authors report a case of tuberculous meningitis in a young man who developed acute hydrocephalus as soon as the fifteenth day of the course of the disease. Attention is drawn to the importance of computerized tomography in investigating sudden deterioration in patients with tuberculous meningitis. Emphasis is put on the value of a shunt procedure which, in the case reported here, led to immediate improvement before antituberculous chemotherapy could have been effective.