Management and Treatment of Hydrocephalus in Pediatric Patients - Our Experience

Abstract

Introduction: Hydrocephalus is a disturbance of cerebrospinal fluid (CFS) physiology, which causes an increase in the amount of CSF present in the cranium, which most commonly results in increased pressure against the brain tissue. CSF diversionary surgery still remains one of the most common procedures in neurosurgery. Cerebrospinal fluid diversion procedures remain the principal method of treatment of hydrocephalus. Commonly used procedures are ventriculo-peritoneal shunt, endoscopic third ventriculostomy and external ventricular drainage. Aim: The objective was to analyze incidence, indications, and complications related to ventriculoperitoneal shunt surgery in pediatric patients. Material and Methods: A retrospective study performed at the Clinic of Pediatric surgery - Department of Neurosurgery, Institute for Child and Youth Health Care of Vojvodina from 2009-2014. Demographic datas (age, sex), indications, complications and mortality/morbidity were analyzed. Results: The total number of performed procedure was 62 (35 girls and 27 boys). Ventriculoperitoneal shunt was performed in 57 patients. Endoscopic third ventriculostomy was performed in 5 patients. The most common indication for ventriculoperitoneal shunt was for congenital hydrocephalus (33), intracranial tumors (13), post infection (7), and for others (granulomatous lesion). Shunt obstruction (18.7%) was most common among the complications, followed by infection (7.15%). Conclusion: Hydrocephalus is a complicated condition to diagnose, and treatment options are limited. Current long-term treatment options are restricted to surgical interventions, including shunt placement and ETV. The treatment of hydrocephalus often requires long-term care and lifelong follow-up, especially in children and neonates in whom there is a congenital cause.