Neurodevelopmental outcome in children with fetal hydrocephalus

Thirty-eight children with fetal hydrocephalus treated surgically during the neonatal period were analyzed concerning their neurodevelopmental outcome by means of a follow-up study. The mean gestation at diagnosis was 31.1 weeks, and the mean postconceptual age at the first operation was 36.3 weeks. The ages of the patients at the last follow-up ranged from 3.8 to 11.8 years (mean = 7.4 years of age). During the follow-up period, they underwent neurologic examinations and were also evaluated to determine the developmental quotient or intelligence quotient. The relationships between age at diagnosis or the first operation for hydrocephalus and neurodevelopmental outcome, and between the lateral ventricular width/hemispheral width ratio at diagnosis and age at diagnosis or the first operation, and neurodevelopmental outcome were statistically evaluated. The neurodevelopmental outcome in the patients was normal in three patients, borderline intelligence in one patient, mental retardation in seven patients, and motor disturbance in 27 patients (five of whom were intellectually normal). The etiology was a major determinant of the outcome in the children with early postnatal surgical treatment of fetal hydrocephalus. Furthermore, an early onset and a high lateral ventricular width/hemispheral width ratio at diagnosis of hydrocephalus were significantly correlated with a poor intellectual outcome.