Child's Nervous System

, 25:795 | Cite as

On the changing epidemiology of hydrocephalus

  • Luca Massimi
  • Giovanna Paternoster
  • Teresa Fasano
  • Concezio Di Rocco
Invited Paper
First Online:
Received:

Abstract

Purpose

The purpose of this study is to evaluate the changing epidemiology of paediatric hydrocephalus over the past three decades in a single institution.

Methods

All children treated for newly diagnosed hydrocephalus during the 1985–1990 (group A) and the 2000–2005 periods (group B) were enrolled and classified according to the associated cause of hydrocephalus.

Results

A significant 8.8% decrease of the incidence of hydrocephalus was noticed between the two time periods, resulting from the reduction of hydrocephalus associated to myelomeningocele, aqueduct stenosis (p = 0.04), CNS infection (p = 0.03), cranio-cerebral malformation and head injuries; post-haemorrhagic hydrocephalus remained stable, while the tumour-associated one increased (p < 0.0001). No consistent differences in terms of rate of adjunctive surgery (30.3% versus 23.9%) and number revision procedures (200 versus 104) were recorded.

Conclusions

The present study confirmed data from the literature about the declined incidence of paediatric hydrocephalus, which mainly results from the decrease of congenital malformations. In spite of the recent advances in neuroendoscopy and in the shunting valve design, the impact of hydrocephalus in the paediatric neurosurgical practice remains high.

Keywords

Hydrocephalus Epidemiology Myelomeningocele Preterm haemorrhage Aqueduct stenosis 
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References

  1. 1.
    Beni-Adani L, Biani N, Ben-Sirah L, Constantini S (2006) The occurrence of obstructive vs absorptive hydrocephalus in newborns and infants: relevance to treatment choices. Childs Nerv Syst 22:1543–1563PubMedCrossRefGoogle Scholar
  2. 2.
    Blackburn BL, Fineman RM (1994) Epidemiology of congenital hydrocephalus in Utah, 1940–1979: report of an iatrogenically related “epidemic”. Am J Med Genet 52:123–129PubMedCrossRefGoogle Scholar
  3. 3.
    Bondurant CP, Jimenez DF (1995) Epidemiology of cerebrospinal fluid shunting. Pediatr Neurosurg 23:254–258PubMedCrossRefGoogle Scholar
  4. 4.
    Casey AT, Kimmings EJ, Kleinlugtebeld AD, Taylor WA, Harkness WF, Hayward RD (1997) The long-term outlook for hydrocephalus in childhood. A ten-year cohort study of 155 patients. Pediatr Neurosurg 27:63–70PubMedCrossRefGoogle Scholar
  5. 5.
    Di Rocco C, Cinalli G, Massimi L, Spennato P, Cianciulli E, Tamburrini G (2006) Endoscopic third ventriculostomy in the treatment of hydrocephalus in pediatric patients. Adv Tech Stand Neurosurg 31:119–219PubMedCrossRefGoogle Scholar
  6. 6.
    Di Rocco C, Massimi L, Tamburrini G (2006) Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst 22:1573–1589PubMedCrossRefGoogle Scholar
  7. 7.
    Drake JM (2007) The surgical management of pediatric hydrocephalus. Neurosurgery 62(Suppl. 2):633–640Google Scholar
  8. 8.
    Fernell E, Hagberg G, Hagberg B (1994) Infantile hydrocephalus epidemiology: an indicator of enhanced survival. Arch Dis Child 70:F123–F128CrossRefGoogle Scholar
  9. 9.
    Frey L, Hauser WA (2003) Epidemiology of neural tube defects. Epilepsia 44(Suppl 3):4–13PubMedCrossRefGoogle Scholar
  10. 10.
    Futagi Y, Suzuki Y, Toribe Y, Nakano H, Morimoto K (2005) Neurodevelopmental outcome in children with posthemorrhagic hydrocephalus. Pediatr neurol 33:26–32PubMedCrossRefGoogle Scholar
  11. 11.
    Green AL, Pereira EAC, Kelly D, Richards PG, Pike MG (2007) The changing face of pediatric hydrocephalus: a decade’s experience. J Clin Neurosci 14:1049–1054PubMedCrossRefGoogle Scholar
  12. 12.
    Heisenbergen I, Rotteveel J, Roeleveld N, Grotenhuis A (2002) Outcome in shunted hydrocephalic children. Eur J Ped Neurol 6:99–107CrossRefGoogle Scholar
  13. 13.
    Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY (2001) Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA 285:2981–2986PubMedCrossRefGoogle Scholar
  14. 14.
    ISTAT (2008) Natalità e fecondità della popolazione residente: caratteristiche e tendenze recenti. Anno 2006. www.demo.istat.it
  15. 15.
    Kadri H, Mawla AA, Kazah J (2006) The incidence, timing, and predisposing factors of germinal matrix and intraventricular hemorrhage (GMH/IVH) in preterm neonates. Childs Nerv Syst 22:1086–1090PubMedCrossRefGoogle Scholar
  16. 16.
    Koch-Wiewrodt D, Wagner W (2006) Success and failure of endoscopic third ventriculostomy in young infants: are there different age distributions? Childs Nerv Syst 22:1537–1541PubMedCrossRefGoogle Scholar
  17. 17.
    Lemire RJ (1988) Neural tube defects. JAMA 259:558–562PubMedCrossRefGoogle Scholar
  18. 18.
    Moritake K, Nagai H, Miyazaki T, Nagasako N, Yamasaki M, Tamakoshi A (2007) Nationwide survey of the etiology and associated conditions of prenatally and postnatally diagnosed congenital hydrocephalus in Japan. Neurol Med Chir (Tokyo) 47:448–452CrossRefGoogle Scholar
  19. 19.
    Moritake K, Nagai H, Nagasako N, Yamasaki M, Oi S, Hata T (2008) Diagnosis of congenital hydrocephalus and delivery of its patients in Japan. Brain Dev 30:381–386PubMedCrossRefGoogle Scholar
  20. 20.
    Murshid WR, Jarallah JS, Dad MI (2000) Epidemiology of infantile hydrocephalus in Saudi Arabia: birth prevalence and associated factors. Pediatr Neurosurg 32:119–123PubMedCrossRefGoogle Scholar
  21. 21.
    Nakashima S, Watanabe K, Negoro T, Aoki K, Kikuchi H (1996) Clinico-epidemiological features of infantile hydrocephalus in Japan. Acta Pediatr Jap 38:567–575Google Scholar
  22. 22.
    Patwardhan RV, Nanda A (2005) implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery 56:139–145PubMedGoogle Scholar
  23. 23.
    Peacock WJ, Currer TH (1984) Hydrocephalus in childhood. A study of 440 cases. S Afr Med J 66:323–324PubMedGoogle Scholar
  24. 24.
    Pereira EAC, Fieggen AG, Kelly D, Richards PG, Pike MG (2004) The etiology of pediatric hydrocephalus: Oxford and Cape Town compared. Childs Nerv Syst 20:266Google Scholar
  25. 25.
    Persson E-K, Anderson S, Wiklund L-M, Uvebrant P (2007) Hydrocephalus in children born in 1999–2002: epidemiology, outcome and ophthalmological findings. Child’s Nerv Syst 23:1111–1118CrossRefGoogle Scholar
  26. 26.
    Persson E-K, Hagberg G, Uvebrant P (2005) Hydrocephalus prevalence and outcome in a population-based cohort of children born in 1989–1998. Acta Paediatrica 94:726–732PubMedCrossRefGoogle Scholar
  27. 27.
    Schrander-Stumpel C, Fryns JP (1998) Congenital hydrocephalus: nosology and guidelines for clinical approach and genetic counselling. Eur J Pediatr 157:355–362PubMedCrossRefGoogle Scholar
  28. 28.
    Serlo W, Fernell E, Heikkinen E, von Wendt L (1990) Functions and complications of shunts in different etiologies of childhood hydrocephalus. Childs Nerv Syst 6:92–94PubMedCrossRefGoogle Scholar
  29. 29.
    Sgouros S, Kulkharni AV, Constantini S (2006) The International Infant Hydrocephalus Study: concept and rational. Childs Nerv Syst 22:338–345PubMedCrossRefGoogle Scholar
  30. 30.
    Tuli S, Drake J, Lawless J, Wigg M, Lamberti-Pasculli M (2000) Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 92:31–38PubMedCrossRefGoogle Scholar
  31. 31.
    Weatherall JAC (1982) A review of some effects of recent medical practices in reducing the numbers of children born with congenital abnormalities. Department of Health & Social Security, Welsh Office. Health trends 14:85–88PubMedGoogle Scholar
  32. 32.
    Whitelaw A, Thoresen M, Pople I (2002) Posthaemorrhagic ventricular dilatation. Arch Dis Child Fetal Neonatal Ed 86:F72–F74PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Luca Massimi
    • 1
  • Giovanna Paternoster
    • 1
  • Teresa Fasano
    • 1
  • Concezio Di Rocco
    • 1
  1. 1.Paediatric Neurosurgery–Institute of NeurosurgeryRomeItaly

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