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Published on: October 2, 2014
Management of hydrocephalus using the Chabbra shunt
1Department of Surgery, University of Malawi College of Medicine, Blantyre.
Insights
This study on hydrocephalus patients found that meningitis and congenital causes were most common. Ventriculo-peritoneal shunting was successful in 73% of cases, with complications including infection and blockage.
Area of Science:
- Neuroscience
- Pediatric Surgery
- Neurosurgery
Background:
- Hydrocephalus is a significant neurological condition requiring timely intervention.
- Identifying common etiologies and treatment outcomes is crucial for patient management.
- Queen Elizabeth Central Hospital manages a substantial number of hydrocephalus cases.
Purpose of the Study:
- To investigate the causes, diagnostic methods, and treatment outcomes of hydrocephalus.
- To evaluate the efficacy and complications of ventriculo-peritoneal shunting in hydrocephalus patients.
- To analyze patient demographics and mortality rates associated with hydrocephalus treatment.
Main Methods:
- Retrospective analysis of 223 hydrocephalus patients over two years.
- Diagnostic imaging included ultrasonography for infants and CT scans for older patients.
- Ventricular aspiration was used to assess cerebrospinal fluid (CSF) clarity before shunting.
Main Results:
- Meningitis and congenital hydrocephalus were the most frequent causes.
- 157 patients with clear CSF proceeded to ventriculo-peritoneal (VP) shunt insertion.
- Satisfactory outcomes were achieved in 73% of patients; common complications included shunt infection (7.6%) and blockage (3.8%).
Conclusions:
- VP shunting is an effective treatment for hydrocephalus, but complication rates require attention.
- Early diagnosis and appropriate management are key to improving outcomes in hydrocephalus.
- Further research into reducing shunt-related complications is warranted.
Abstract:
Over a two-year period, 223 patients with hydrocephalus were admitted to the wards of Queen Elizabeth Central Hospital, Blantyre. Of these 223 patients, 111 were male and 112 were female. All children of less than 18 months underwent ultrasonography to confirm the diagnosis of hydrocephalus, and 22 older patients had a CT scan. The commonest causes of hydrocephalus were meningitis and congenital hydrocephalus. 201 had ventricular aspiration to assess suitability for shunting and in 157 patients, the cerebrospinal fluid (CSF) was clear and these patients were considered suitable for insertion of a ventriculo-peritoneal (VP) shunt. The outcome was satisfactory in 73% of the patients with 10 patients lost to follow-up. There were 12 (7.6%) patients with shunt infections, 6 (3.8%) patients had peritoneal shunt blockage and 2 (1.3%) had over-drainage. There were 2 cases of shunt prolapsing through the anus. Twenty patients died (12.7%): one had inflammation along the shunt tract, one had valve malfunction and one had the valve exposed on the scalp.
