Abstract
Background
Predicting the outcome of congenital hydrocephalus in early infancy and childhood is difficult. Various consequences of hydrocephalus like ophthalmic, audiometric, musculoskeletal, and the developmental abnormalities play a complex role. We analyzed the quality of life of these patients in early life.
Methods
A prospective multispecialty assessment of the patients with congenital hydrocephalus, who had undergone ventriculoperitoneal shunt in the Pediatric Surgery unit of a tertiary care hospital, was carried out and analyzed.
Results
There were 24 boys and 6 girls. Eighty-three percent were operated before the age of 3 months. Mean age at follow up was 6 years (3–9 years). Shunt complications were seen in 53 % (16) of the patients, out of which 68.75 % had shunt blocks. In 70 % (21) of the patients, the ventricle to hemisphere ratio (VHR) was between 51 and 70 %, 20 % (6) had a VHR of more than 70 % and only 3 patients had a VHR between 40–50 %. Audiological and ophthalmic problems were seen in 20 and 66 % of the children, respectively. Musculoskeletal abnormalities were present in 36 % of the patients. Developmental profile showed 44 % being normal, 30 % retarded, and 26 % were borderline cases. The schooling had started in 56.6 %, out of which only one child went to a special school.
Conclusions
A multitude of problems associated with congenital hydrocephalus should be diligently diagnosed, aggressively followed and intervened with in the early years of life. Preschool management well before the peer interaction should optimize the social integration and improve the quality of life in these patients.
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References
Paulsen AH, Lundar T, Lindegaard KF (2010) Twenty-year outcome in young adults with childhood hydrocephalous: assessment of surgical outcome, work participation and health related quality of life. J Neurosurg Pediatr 6:527–535
Alpern GD, Thomas BJ, Shearer M (1985) Developmetal profile II; Manual. Western psychological services
Hoppe–Hirsch E, Laroussini F (1998) Late outcome of the surgical treatment of hydrocephalous. Childs Nerv Syst 14:97–99
Di Rocco C, Marchese E (1994) A survey of the first complication of newly implanted CSF shunt devices for the treatment of non tumoral hydrocephalous. Childs Nerv Syst 10:321–327
Stone JJ, Walker TC, Jacobs MBS (2013) Revision rate for ventriculoperitoneal shunts after 15 years. J Neurosurg Pediatr 11:15–19
Persson EK, Anderson S, Wiklund ML (2007) Hydrocephalus in children born in 1999–2002: epidemiology, outcome and ophthalmological findings. Childs Nerv Syst 23:1111–1118
Kulkarni AV, Rabin D, Lamberti-Pasculli M, Drake JM (2001) Repeat cerebrospinal fluid shunt infection in children. Pediatr Neurosurg 35:66–71
Choux M, Genitori L, Lang D, Lena G (1992) Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 77:875–880
Donders J, Canady AI, Rourke BP (1990) Psychometric intelligence after infantile hydrocephalous. Childs Nerv Syst 6:148–154
Krauss JK, Faist M, Schubert M (2001) Evaluation of gait in normal pressure hydrocephalus before and after shunting. In: R’uzicka E, Hallett M, Jankovic J (eds) Gait Disorders. Lippincott Williams & Wilkins, Philadelphia, PA, pp 301–309
Kulkarni AV, Shams IJ (2007) Quality of life in children with hydrocephalous: results from hospital for sick children, Toronto. J Neurosurg Pediatr 107:358–364
Young HF, Nulsen FE, Weiss MH, Thomas P (1973) The relationship of intelligence and cerebral mantle in treated infantile hydrocephalus. (IQ potential in hydrocephalic children). J Pediatr 52:38–44
Rubin RC, Hockwald G, Teill M, Epstein F, Ghatak N, Wisniewski H (1976) Hydrocephalous III; reconstitution of cerebral cortical mantle following ventricular shunting. Surg Neurol 5:179–183
Haines SJ (1999) Shunt infections. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of neurosurgery. Thieme, New York, pp 1177–1185
Scott MA (1998) Memory functions in children with early hydrocephalous. Neuropsychology 12:578–589
Kraus N, Ozdamer O, Heydemann PT, Stein L, Reed NL (1984) Auditory brainstem responses in hydrocephalous patients. Electroencephalogr Clin Neurophysiol 59:310–317
Venkatramana NK (1988) Evaluation of brain stem auditory evoked responses in congenital hydrocephalous. Childs Nerv Syst 4:334–338
Rudolph D, Sterker I, Graefe G (2010) Visual field constriction in children with shunt-treated hydrocephalus. J Neurosurg Pediatr 6:481–485
Ozgul A, Volkan E (2005) Risk of strabismus and amblyopia in children with hydrocephalous. Graefes Arch Clin Exp Ophthalmol 243:1213–1217
Casey A, Kimmings EJ, Kleinlugtebeld AD, Taylor WA, Harkness WF, Hayward RD (1998) The long term outlook for hydrocephalous in childhood: a ten year cohort study of 155 patients. Pediatr Neurosurg 27:63–70
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Peters, N.J., Mahajan, J.K., Bawa, M. et al. Factors affecting quality of life in early childhood in patients with congenital hydrocephalus. Childs Nerv Syst 30, 867–871 (2014). https://doi.org/10.1007/s00381-013-2335-x
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DOI: https://doi.org/10.1007/s00381-013-2335-x