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Adult outcome of pediatric hydrocephalus

Matthieu Vinchon1, Marc Baroncini, Isabelle Delestret

  • 1Department of Pediatric Neurosurgery, Hôpital Roger Salengro, Lille University Hospital, CHRU de Lille, Lille Cedex, France. matthieu.vinchon@chru-lille.fr

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|February 22, 2012
PubMed

Insights

Pediatric hydrocephalus patients require lifelong care, with many experiencing long-term motor and cognitive issues. Adult outcomes highlight the need for organized transition to adult neurosurgery services.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Long-term Patient Outcomes

Background:

  • Pediatric hydrocephalus management has advanced, but adult outcomes remain under-documented.
  • Understanding the long-term healthcare needs of adults treated for childhood hydrocephalus is crucial for care planning.
  • This study reviews long-term data from a pediatric hydrocephalus cohort followed into adulthood.

Purpose of the Study:

  • To determine the long-term healthcare profile and outcomes of individuals treated for hydrocephalus in childhood.
  • To identify the need for lifelong follow-up and organized transition to adult neurosurgical care.

Main Methods:

  • Retrospective review of a pediatric hydrocephalus database from a single institution covering a large population.
  • Inclusion criteria: patients treated for hydrocephalus before age 18 and followed up past age 20.
  • Data analysis included shunt revision rates, weaning from shunts, mortality, and long-term neurological sequels.

Main Results:

  • Of 456 patients followed for a mean of 24.2 years, 17.8% required shunt operations after age 20.
  • Significant long-term sequels included motor (46.5%) and cognitive (47.6%) deficits; only 18% had no sequels.
  • Adult employment and schooling were limited, with 54.5% having IQ ≥80 but only 41.4% normal schooling and 33.7% competitive employment.

Conclusions:

  • Individuals treated for hydrocephalus in childhood necessitate lifelong neurosurgical follow-up.
  • While late mortality is low, morbidity is substantial, with a significant proportion requiring adult shunt surgeries.
  • Organized transition protocols from pediatric to adult neurosurgery are essential for this vulnerable patient group.
Abstract

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