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Neuroophthalmological symptoms in children treated for internal hydrocephalus
C Tzekov1, S Cherninkova, T Gudeva
1Clinic of Neurosurgery, Medical Academy, Sofia, Bulgaria.
Insights
Visual function disorders are common in children with hydrocephalus, often appearing before CT scan changes. These neuro-ophthalmological findings are crucial for early diagnosis and treatment of pediatric hydrocephalus.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatric Neurology
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Elevated intracranial pressure in pediatric hydrocephalus can lead to various neurological and visual impairments.
Purpose of the Study:
- To investigate the prevalence and types of visual function disorders in children with hydrocephalus.
- To assess the significance of neuro-ophthalmological symptoms in the early diagnosis and management of pediatric hydrocephalus.
Main Methods:
- Retrospective analysis of 126 children with hydrocephalus treated between 1978-1990.
- Preoperative classification of hydrocephalus etiology and assessment of visual function disorders.
- Evaluation of neuro-ophthalmological symptoms in children requiring shunt revision due to malfunction.
Main Results:
- Preoperative visual function disorders were identified in 48.4% of children.
- Common visual impairments included the "setting sun" sign, Sylvian aqueduct syndrome, and craniocerebral nerve paresis.
- Neuro-ophthalmological symptoms were also prevalent in children with shunt malfunction, indicating ongoing intracranial pressure issues.
Conclusions:
- Visual function disorders frequently accompany pediatric hydrocephalus and elevated intracranial pressure.
- Neuro-ophthalmological findings can precede changes visible on CT scans, highlighting their importance for early diagnosis.
- Monitoring visual functions is critical for timely intervention in hydrocephalus management.
Abstract:
The object of the study are 126 children with internal hydrocephalus treated within the period 1978-1990. The children were preoperatively divided into six groups according to the etiology of the hydrocephalus. Disorders of the visual functions accompanying elevated intracranial pressure (setting sun 51, syndrome of the aqueduct of Sylvius 14, paresis of craniocerebral nerves 9, nystagmus 8, optic atrophy 4) were established preoperatively in 48.4% of the children. 44 of the children were revised because of malfunction of the shunt with the following neuroophthalmological symptoms: setting sun 6, paresis of craniocerebral nerves 9, syndrome of the Sylvius aqueduct 6, papilledema 6, optic atrophy 9 and nystagmus 5. The fact that a great many changes in the visual functions sometimes precede the manifestations of the changes in CT image determines their significance for early diagnosis and treatment.