Evaluation of Pediatric Hydrocephalus: Clinical, Surgical, and Outcome Perspective in a Tertiary Center.

Abstract

Context:Pediatric hydrocephalus (PH) results in significant clinical and psychosocial morbidity in pediatric population.Aims:The aims of the study are to evaluate clinical, surgical, and outcome perspective of PH patients of age <12 years.Settings and Design:This is a retrospective cohort study.Materials and Methods:This study includes 117 pediatric patients (age ≤12 years) of hydrocephalus due to various etiology admitted in our department between September 2018 and December 2020. Demographic profile, etiology, clinical presentation, management, complications and postoperative outcome characteristics were evaluated. Survival analysis was done with respect to etiology and age group.Statistical Analysis Used:P < 0.05 was considered statistically significant. Unpaired t-test and Chi-square test were used. Kaplan–Meier curve plotting and survival analysis were also done.Results:Male-to-female ratio was 1.3:1. Most frequent etiology of PH was postinfectious (35%). Posterior fossa pilocytic astrocytoma (34.2%) was the most common neoplastic etiology. Surgical procedure performed for PH was ventriculoperitoneal shunting (n = 103), Ommaya reservoir (n = 2) placement, and endoscopic third ventriculostomy (ETV) (n = 8). Mortality was significantly (P = 0.0139) more in patients of neoplastic etiology. Cognitive deficits and delayed developmental milestones were significantly (P < 0.05) more in congenital hydrocephalus etiology. There was a nonsignificant difference in survival between age groups (P = 0.1971). However, a significant survival difference was evident (P = 0.0098) for etiology.Conclusions:Disease-specific mortality is main cause of mortality in PH. Neoplastic etiology PH has poor survival when compared to others. Life-long routine controls are required to avoid future possible complications and enhance better rehabilitation of the child.