The Long-Term Outlook for Hydrocephalus in Childhood
| Autor: | A.T.H. Casey, W.A.S. Taylor, Richard D. Hayward, William Harkness, A.D. Kleinlugtebeld, E. Kimmings |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Pediatrics business.industry Retrospective cohort study General Medicine medicine.disease Hydrocephalus Shunt (medical) Surgery Intraventricular hemorrhage Pediatrics Perinatology and Child Health Cohort medicine Neurology (clinical) Neurosurgery business Complication Cohort study |
| Zdroj: | Pediatric Neurosurgery. 27:63-70 |
| ISSN: | 1423-0305 1016-2291 |
| DOI: | 10.1159/000121229 |
| Popis: | Despite the fact that ventriculoperitoneal shunt insertion is the most commonly performed surgical operation in the pediatric neurosurgeon's repertoire, there is a surprising paucity of long-term outcome studies for these patients detailing either the complication rate over a predetermined time period or more importantly their intellectual outcome. The aims of this study, therefore, were to determine the 10-year outcome in a cohort of 155 children with shunted hydrocephalus, both in terms of the number and time sequence of shunt complications and also the long-term academic (schooling) outcome of these individuals. This was a cohort study of 155 hydrocephalic children who underwent first-time ventriculoperitoneal shunt insertion between the years 1978 and 1983, who were then followed up on an annual outpatient basis for a period of 10 years or until death. Their academic records and the surgical morbidity and mortality encountered over the 10-year study period were used as the main outcome measures. For those children surviving until schoolage, 59% were able to attend a normal school. The academic outlook for those children with hydrocephalus secondary to infection (postmeningitic) or intraventricular hemorrhage was less favorable with 52 and 60% requiring special schooling compared to those children with congenital hydrocephalus (29%; p = 0.036). 44% (68/155) of patients in this cohort did not require a shunt revision. The commonest reasons for shunt revision were blockage (49%) and infection (19%) which predominantly occurred within the first year of their original shunt procedure. Overall the infection rate was 12% (44/380 procedures). Furthermore an increased incidence of shunt infection was noted in those under 6 months old (p = 0.040). There was an 11 % mortality during the 10-year follow-up period for those with nontumor-related hydrocephalus. |
| Databáze: | OpenAIRE |
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