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Intellectual functioning in children with early shunted posthemorrhagic hydrocephalus
Maureen Lacy1, Benjamin A Pyykkonen, Scott J Hunter
1Department of Psychiatry, University of Chicago, Chicago, IL 60637, USA.
Pediatric Neurosurgery
|August 16, 2008
Summary
Children with hydrocephalus shunted in infancy show significantly lower intellectual functioning than peers. This study found no discrepancy between verbal and performance IQ, possibly due to patient selection.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pediatric Neurosurgery
Background:
- Cognitive impairments in children with hydrocephalus require early intervention for optimal outcomes.
- Increasing survival rates necessitate a better understanding of cognitive and behavioral functioning in hydrocephalic children.
- Existing literature shows variable findings regarding the extent and specifics of cognitive deficits in hydrocephalus.
Purpose of the Study:
- To investigate the pattern of cognitive impairment in children with hydrocephalus uniformly shunted with a nonsiphoning valve in infancy.
- To compare the intellectual functioning of children with hydrocephalus to age- and education-matched controls.
Main Methods:
- A cohort of 41 children with congenital hydrocephalus, shunted in the first year of life, was compared to 16 unaffected controls.
- Participants underwent a comprehensive neuropsychological assessment using the Wechsler Intelligence Scale for Children, Third Edition (WISC-III).
- Intellectual functioning measures, including full-scale, verbal (VIQ), and performance (PIQ) IQ, were compared between the groups.
Main Results:
- Children with hydrocephalus scored approximately one standard deviation lower than controls on general intellectual functioning (mean FSIQ 83.8 vs. 102.9).
- Significant deficits were observed in both verbal IQ (86.6 vs. 107.1) and performance IQ (83.6 vs. 98.2) compared to controls.
- No significant correlation was found between intellectual functioning and history of shunt revisions, infections, prematurity, seizures, or hemorrhage. Statistically similar VIQ/PIQ performance was noted within the hydrocephalus group.
Conclusions:
- Children with hydrocephalus in this selected cohort exhibit normally distributed but significantly lower intellectual functioning than their nonaffected peers.
- Unlike previous studies, this research did not find significant discrepancies between verbal and performance IQ in the studied population.
- The selective nature of the study population may explain the absence of VIQ/PIQ discrepancies, suggesting a differential impact of hydrocephalus etiology and treatment on cognitive outcomes.
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