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Prenatal hydrocephalus: outcome and prognosis
D Renier1, C Sainte-Rose, A Pierre-Kahn
1Hôpital des Enfants Malades, Paris, France.
Summary
Long-term outcomes for infant hydrocephalus surgery show a 62% survival rate at 10 years. Functional results indicate significant intellectual and academic challenges for many survivors, highlighting the need for ongoing support.
Area of Science:
- Pediatric Neurosurgery
- Developmental Pediatrics
- Clinical Neurology
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Early surgical intervention is crucial for infants diagnosed with hydrocephalus at birth.
Purpose of the Study:
- To evaluate the long-term functional outcomes of infants treated for hydrocephalus.
- To identify factors influencing survival and developmental status post-surgery.
Main Methods:
- Retrospective review of clinical records for 108 infants operated on for hydrocephalus between 1971 and 1981.
- Exclusion of premature newborns and patients with spina bifida.
- Assessment of functional results based on intellectual performance, academic level, and psychological status, with a mean follow-up of 7 years.
Main Results:
- A 10-year survival rate of 62% was observed.
- Among survivors, 28% had an IQ over 80, while 50% had an IQ under 60 (mean IQ 54).
- Only 29% of school-aged children achieved a normal academic level; 46% had normal or borderline psychological status.
Conclusions:
- Long-term functional outcomes in operated infants with hydrocephalus are often suboptimal, with significant intellectual and academic deficits.
- Favorable outcomes were associated with the absence of malformations, no shunt infections, aqueductal stenosis as the cause, and higher early developmental quotients.
- Head size at birth, ventricular size, and age at surgery did not correlate with late functional results.