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Updated: Jun 18, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Comparing motor development in children with hydrocephalus after treatment with ventriculoperitoneal shunt and
Martha Manda1, Eveness Nambuzi1, Frank Kaphesi1
1Department of Rehabilitation Sciences, School of Life Science and Allied Health Professions, Kamuzu University of Health Sciences, Blantyre, Malawi.
Insights
Pediatric hydrocephalus treatment with Ventriculoperitoneal shunt insertion (VPSI) or endoscopic third ventriculostomy (ETV) showed motor development delays in children. Both surgical approaches resulted in similar motor outcomes up to two years post-treatment.
Area of Science:
- Pediatric neurosurgery
- Developmental pediatrics
- Global health
Background:
- Hydrocephalus is a common neurological condition in children, often requiring surgical intervention.
- Ventriculoperitoneal shunt insertion (VPSI) and endoscopic third ventriculostomy (ETV) are primary surgical treatments.
- Limited comparative data exists on motor development outcomes following VPSI versus ETV in pediatric hydrocephalus.
Purpose of the Study:
- To compare motor development outcomes in children with hydrocephalus treated with VPSI or ETV.
- To identify the more effective surgical approach for Malawian children.
- To assess motor development up to two years post-surgery.
Main Methods:
- Cross-sectional study design.
- Recruitment of children with hydrocephalus treated with VPSI or ETV at least 6 months prior.
- Neurodevelopmental assessment using the Malawi Development Assessment Tool (MDAT).
Main Results:
- 25 children (12 VPSI, 13 ETV) were assessed.
- Motor development delays were observed in both gross and fine motor domains for most children.
- No significant difference in motor development was found between the VPSI and ETV groups.
Conclusions:
- Children with hydrocephalus experience motor development delays post-VPSI or ETV treatment.
- Early and intensive rehabilitation may be crucial for motor function recovery.
- Long-term studies with larger sample sizes are needed to confirm treatment efficacy.
Introduction:
Ventriculoperitoneal shunt insertion (VPSI) and endoscopic third ventriculostomy (ETV) are the major procedures for treating pediatric hydrocephalus. However, studies comparing motor development following the two treatments are limited.
Objective:
We aimed to determine motor development outcomes in children with hydrocephalus up to 2 years of age after undergoing VPSI or ETV, to identify which surgical approach yields better motor outcomes and may be more effective for Malawian children.
Methods:
This was a cross-sectional study where we recruited two groups of participants: one group consisted of children with hydrocephalus treated with VP shunt whilst the other group were treated with ETV, at least 6 months prior to this study. Participants were identified from the hospital records and were called to come for neurodevelopmental assessment using the Malawi Development Assessment Tool (MDAT).
Results:
A total 152 children treated for hydrocephalus within an 18-month period met the inclusion criteria. Upon follow up and tracing, we recruited 25 children who had been treated: 12 had VPSI and 13 had ETV. MDAT revealed delays in both assessed motor domains: 19 out of the 25 children had delayed gross motor whilst 16 of 25 had delayed fine motor development. There was no significant difference between the shunted and the ETV groups.
Conclusion:
Children with hydrocephalus demonstrate delays in motor development six to 18 months after treatment with either VPSI or ETV. This may necessitate early and prolonged intensive rehabilitation to restore motor function after surgery. Long-term follow-up studies with bigger sample sizes are required to detect the effect of the two treatment approaches.
