The effects of multiple shunt revisions on neuropsychological functioning and memory

Abstract

The focus of this study was to determine the effect of multiple shunt revisions on cognition and memory. The present study attempted to document a discrepancy in the functioning of children with hydrocephalus having numerous shunt revisions compared to those with only an initial shunt surgery. Researchers have found an increasing number of children with hydrocephalus requiring shunt revisions. In the current literature there are many conflicting views regarding the effects of hydrocephalus on cognition and memory. Many researchers report that properly treated hydrocephalus will not have a negative impact on cognitive functioning. Furthermore, researchers found that factors such as the total number of shunt revisions do not negatively impact global intellectual ability. Forty-six subjects between the ages of six and 16 years participated in the study. The subjects were recruited from the Department of Neurosurgery at an urban pediatric hospital. Specific inclusion and exclusion criteria were met. Independent variables for the study included shunt revisions; seizures, and Attention Deficit Hyperactivity Disorder (ADHD). Subject groupings were based on whether the subjects required multiple shunt revisions or single shunt placement and the presence or absence of seizures and ADHD. Dependent variables included the subject’s performance on measures of cognition and memory. Measures of functioning included the Wechsler Intelligence Scale for Children-Third Edition and the Wide Range Assessment of Learning and Memory- Screener. The results of this study did not support the presence of cognitive or memory impairments as a result of multiple shunt revisions. Anecdotal findings noted that seizures were the only independent variable to significantly account for the observed variance in scores of cognition, specifically Full Scale IQ, Verbal Comprehension, and Perceptual Organization. [Neurol Res 2000; 22: 131-136]