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Huge hydrocephalus: definition, management, and complications

Morteza Faghih Jouibari1, Nazanin Baradaran, Rouzbeh Shams Amiri

  • 1Department of Neurosurgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|June 16, 2010
PubMed

Insights

Management of huge hydrocephalus (HH) in infants requires careful consideration due to high complication rates. Programmable shunts are recommended to control drainage and mitigate risks like infection and developmental delays.

Area of Science:

  • Pediatric Neurosurgery
  • Neurology
  • Medical Management

Background:

  • Huge hydrocephalus (HH) presents unique challenges compared to common hydrocephalus.
  • Parental socioeconomic factors and lack of knowledge can lead to delayed treatment, resulting in progressive HH and macrocephaly.
  • Effective management strategies are crucial for improving outcomes in infants with HH.

Purpose of the Study:

  • To present the clinical experience in managing infants with huge hydrocephalus (HH).
  • To analyze the causes, treatment outcomes, and complications associated with HH management.
  • To highlight the importance of appropriate shunt technology in HH patients.

Main Methods:

  • Definition of HH: head circumference greater than infant's height.
  • Surgical intervention involved shunting in nine infants diagnosed with HH.
  • Follow-up duration ranged from 0.5 to 7 years post-shunting.

Main Results:

  • Aqueductal stenosis was the most frequent cause of HH.
  • The average age at shunting was 3 months, with head circumferences averaging 67 cm (range 56-94 cm).
  • Five patients had age-appropriate cognitive status, but only one showed normal motor development. Complications included subdural effusion (6), shunt infection (4), and mortality (3) due to infection/sepsis.

Conclusions:

  • Patients with HH face significant risks of complications post-shunt surgery, including subdural effusion, ventricular collapse, and shunt infection.
  • Mental and motor disabilities are prevalent in infants with HH.
  • Programmable shunts are advised to control overdrainage, a potential cause of complications.
Abstract

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