DOI: http://dx.doi.org/10.18203/2349-2902.isj20201408

Clinical study and management of hydrocephalus in children

Santoshkumar N. Deshmukh, Ashishkumar T. Yadav

Abstract


Background: Hydrocephalus is a condition in which an accumulation of cerebrospinal fluid (CSF) occurs within the brain. Hydrocephalus can occur at any age, but it is more common in infants. Long-term complications of hydrocephalus can vary widely and are often difficult to predict and may result in significant intellectual, developmental and physical disabilities. Ventriculoperitoneal shunt remains mainstay of treatment even today as it is easily available and inexpensive.

Methods: The study was conducted in Dr. V. M. Government Medical College and Hospital located in Solapur (Maharashtra) from September 2016 to 2018.  It was a prospective descriptive study. 30 cases up to the age 14 years with diagnosis of hydrocephalus undergoing VP (ventriculo-peritoneal) shunt surgery were included in the study.

Results: Aqueductal stenosis and tuberculous meningitis were the commonest causes of congenital and acquired hydrocephalus in children respectively. Shunt infection and shunt obstruction were the commonest post-operative complications required shunt revision. Low birth weight and other associated congenital anomalies increased the mortality rate.

Conclusions: VP shunt placement has been the main treatment modality for hydrocephalus. VP shunts procedures are associated with complications and morbidity. Number of revision shunt procedures, low birth weight, associated congenital anomalies adversely affected the final surgical outcome.


Keywords


Hydrocephalus, Chhabra’s shunt, Children

Full Text:

PDF

References


Pereira SA, Costa MF. Visual acute evaluation in children with hydrocephalus: An electrophysiological study with sweep visual evoked potential. World J Neurosci. 2012;2:36-43.

Rekate HL. Hydrocephalus in children. In: Winn HR, Youmans JR (eds) Youmans neurological Surgery. Saunders, St. Louis; 2003: 3387-3404.

Mahon BM, Pugh TF, Ingalls TH. Anencephalus, spina bifida, and hydrocephalus incidence related to sex, race, season of birth, and incidence in siblings. Br J Prev Soc Med. 1953;7:211-9.

Zahl SM, Wester K. Routine measurement of head circumference as a tool for detecting intracranial expansion in infants: a nationwide survey. Paediatrics. 2008;121:416-20.

Aschoff A, Kremer P, Hashemi B, Kunze S. The scientific history of hydrocephalus and its treatment. Neurosurg Rev. 1999;22:67-93.

Notarianni C, Vannemreddy P, Caldito G, Bollam P. Congenital hydrocephalus and ventriculoperitoneal shunts: influence of etiology and programmable shunts on revisions. J Neurosurg Pediatr. 2009;4(6):547-52.

Pan P. Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus. J Pediatr Neurosci. 2018;13:176-81.

Kyalo MC, Nganga NH, Kamau MN. Management and functional outcome of childhood hydrocephalus at the kenyatta national hospital, nairobi. AJNS. 2015;34(1):36-44.

Warf BC, Dagi AR, Kaaya BN, Schiff SJ. Five-year survival and outcome of treatment for post infectious hydrocephalus in Ugandan infants. J Neurosurg Pediatr. 2011;8(5):502-8.

Tambo FF, Djientcheu V, Chiabi A. Our experience in the management of infantile hydrocephalus: a study on thirty-five regrouped cases in Yaounde, Cameroon. Afr J Paediatr Surg. 2011;8(2):199-202.

Gathura E, Poenaru D, Bransford R, Albright AL. Outcomes of ventriculoperitoneal shunt insertion in Sub-Saharan Africa. J Neurosurg Pediatr. 2010;6(4):329-35.

Waluza J, Borgestein ES. Management of hydrocephalus using the Chabbra shunt. Malawi. 2005;17(1):7-8.

Rahman MM, Haque MA, Islam MR, Salam AM. Demographic Characteristics and Etiology of Hydrocephalus Patients attended at Tertiary Care Hospital in Bangladesh. J National Institute Neurosci Bangladesh. 2015;1:47-9.

Swati G, Sanjay G, Pankaj Y, Saumya M. CT evaluation of various linear indices in children with clinically suspected hydrocephalus. J Evolution Med Dent Sci. 2017;6(38):3078-82.

Aranha A, Choudhary A, Bhaskar S, Gupta LN. A Randomized Study Comparing Endoscopic third Ventriculostomy versus Ventriculoperitoneal Shunt in the Management of Hydrocephalus Due to Tuberculous Meningitis. Asian J Neurosurg. 2018;13(4):1140-7.

Tascu A, Iliescu A, Rizea RE, Tudose I, Iencean SM. Adult quality of life in congenital hydrocephalus operated cases. A twenty years retrospective study. Romanian Neurosurg. 2015;3:235-8.

Ahmed A, Sandlas G, Kothari P, Sarda D. Outcome analysis of shunt surgery in hydrocephalus. J Indian Assoc Pediatr Surg. 2009;14(3):98-101.

Yusuf AS, Omokanye HK, Adeleke NA. Management and outcome of infantile hydrocephalus in a tertiary health institution in Nigeria. J Neurosci Rural Pract. 2017;8:249-53.

Butler J, Kulkarni AV, Drake JM, Kestle JR. Outcomes of CSF shunting in children: comparison of Hydrocephalus Clinical Research Network cohort with historical controls. J Neurosurg Pediatrics. 2013;12:334-8.

Simon TD, Kronman MP, Whitlock KB, Gove NE. Reinfection after treatment of first cerebrospinal fluid shunt infection: a prospective observational cohort study. J Neurosurg Pediator. 2018;21(4):346-58.

Salvador SF, Henriques JC, Munguambe M, Vaz RM, Barros HP. Hydrocephalus in children less than 1 year of age in northern Mozambique. Surg Neurol. Int. 2014; 8(5):175.

Okoro BA, Ohaegbulam SC. Ventriculo peritoneal shunts in children. A ten-year experience at the University of Nigeria Teaching Hospital, Enugu-Nigeria. West. 1992;11(4):284-91.

Jha R, Khadka N, Kumar P Management of Hydrocephalus:our Experience. PMJN Postgraduate Med J NAMS 2010;10(2):68-70.

Fitzgerald R, Connolly B. An operative technique to reduce valve colonisation. Z Kinder Chir. 1984;39(2):107-8.

Cullough DCM. Symptomatic progressive ventriculomegaly in hydrocephalics with patent shunts and antisiphon devices. Neurosurg. 1986;19(4):617-21.

Mancao M, Miller C, Cochrane B, Hoff C, Sauter K, Weber E. Cerebrospinal fluid shunt infections in infants and children in Mobile, Alabama. Acta Paediatr. 1998; 87(6):667-70.

George R, Leibrock L, Epstein M. Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience. J Neurosurg. 1979;51(6):804-11.