Obstructive Hydrocephalus in Children: Predictive Factors of Ventriculocisternostomy Dysfunction at the University Hospital Center of Conakry

Abstract

The treatment of hydrocephalus is surgical and uses two (2) main methods to date: ventriculoperitoneal shunt (DVP) and endoscopic ventriculocisternostomy (VCS). The latter offers the advantage of avoiding the implantation of a foreign body (valve) in the body. However, there are sometimes dysfunctions that can lead to the evolutionary continuation of hydrocephalus. The objective of this study is to identify factors predictive of VCS dysfunction in cases of obstructive hydrocephalus in children at the University Hospital Center (CHU) in Conakry. This is a mixed analytical study of 32 cases of children aged 0-15 years who received VCS during the study period. Outcomes were evaluated according to Drake and Canadian Pediatric Neurosurgery Group clinical criteria. The hospital frequency was 17% and a sex ratio (M/F) of 1.13. Clinical signs were dominated by progressive macrocraniality (93.8%), bulging fontanel (84.4%), ectasia of scalp veins (68.8%). CSF leakage (9.4%) was the most frequent post-operative complication. We recorded one case of death. The success rate of CSF according to Drake's criteria was 56%. The factors often associated with the dysfunction of the VCS found in this study are essentially: age, bulging fontanelle, ectasia of the scalp veins, arachnoid adhesions, closure of the Sylvius aqueduct and pulsation of the bottom of the 3rd V. In the absence of a statistically significant relationship, it would be useful to analyse these parameters closely on a much larger sample.