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Neurodevelopmental profile in children with benign external hydrocephalus syndrome. A pilot cohort study
Federica Maruccia1,2, Laura Gomáriz3, Katiuska Rosas4
1Neurotrauma and Neurosurgery Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. federica.maruccia@icfo.eu.
Insights
Benign external hydrocephalus (BEH) affects neurodevelopment in nearly half of affected children, with motor delays being common. Early identification of those at risk for persistent delays is crucial for timely intervention.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Hydrocephalus Research
Background:
- Management of benign external hydrocephalus (BEH) in children is debated.
- While many BEH children achieve good long-term outcomes, a significant portion experiences psychomotor delays.
Purpose of the Study:
- To evaluate the frequency and characteristics of neurodevelopmental delays in a cohort of children diagnosed with BEH.
Main Methods:
- A cohort study involved 42 children (6-38 months) with BEH.
- Diagnosis was confirmed by pediatric neurosurgeons using clinical and neuroimaging data.
- Psychomotor development was assessed using the Bayley Scales of Infant and Toddler Development (Bayley-III).
Main Results:
- 43% of BEH children (18 out of 42) showed significantly lower scores in gross motor and composite motor functions compared to healthy children.
- These delays were identified using the Bayley-III assessment tool.
Conclusions:
- A diagnostic approach is needed to differentiate BEH patients with self-limiting delays from those at risk of persistent delays.
- Identifying at-risk children can guide further studies and interventions to improve long-term quality of life.
Purpose:
The management of children with benign external hydrocephalus (BEH) remains controversial. Most BEH children do well in the long-term, but a substantial number have temporary or permanent psychomotor delays. The study aims to assess the prevalence and pattern of neurodevelopmental delay in a cohort of children with BEH.
Methods:
We conducted a cohort study of 42 BEH children (30 boys and 12 girls, aged 6 to 38 months). A pediatric neurosurgeon performed a first clinical evaluation to confirm/reject the diagnosis according to the clinical features and neuroimaging studies. Two trained evaluators assessed the child's psychomotor development using the third edition of the Bayley Scales of Infant and Toddler Development (Bayley-III). Developmental delay was defined as a scaled score < 7 according to the simple scale and/or a composite score < 85.
Results:
Eighteen children (43%) presented statistically lower scores in the gross motor and composite motor of the Bayley-III scales compared to their healthy peers.
Conclusion:
In BEH, it is important to establish a diagnostic algorithm that helps to discriminate BEH patients that have self-limiting delays from those at risk of a persistent delay that should be referred for additional studies and/or interventions that might improve the natural evolution of a disease with high impact on the children and adult's quality of life.
