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Hydrocephalic infants: developmental assessment and computed tomography
Insights
Infants with hydrocephalus and brain injury show lower cognitive scores. Ventricle-brain ratio (VBR) correlates with mental development, but VBR changes over time do not significantly alter cognitive scores in children with shunts.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Shunt placement is a common treatment for hydrocephalus in infants.
- The impact of co-occurring brain injury on cognitive outcomes in infantile hydrocephalus requires further investigation.
Purpose of the Study:
- To investigate the relationship between hydrocephalus, co-existing brain injury, and cognitive development in infants.
- To assess the correlation between ventricular dilatation and cognitive scores.
- To evaluate changes in ventricular size and cognitive function over one year.
Main Methods:
- Studied 29 infants (under 30 months) with shunted hydrocephalus.
- Utilized the Bayley Mental Scale for cognitive assessment.
- Computed the ventricle-brain ratio (VBR) from computed tomography (CT) scans.
Main Results:
- Infants with hydrocephalus and brain injury had significantly lower Bayley Mental Scale scores compared to those with uncomplicated hydrocephalus.
- A negative correlation was observed between VBR and Bayley Mental Scale scores.
- After one year, VBR decreased significantly, but mental quotient remained unchanged in two-thirds of the sample.
Conclusions:
- Brain injury significantly impacts cognitive prognosis in hydrocephalic children.
- Ventricle-brain ratio is an indicator of cognitive function in infants with hydrocephalus.
- While ventricular size can change, cognitive outcomes may stabilize in the short term for shunted hydrocephalic infants.
Abstract:
29 hydrocephalic infants (less than 30 months) who had shunts were studied with the 'Bayley Mental Scale' and with computed tomography. It was found that patients with a medical history indicating brain injury in addition to hydrocephalus had lower scores on the 'Bayley Mental Scale' than a comparable group whose hydrocephalus had been uncomplicated. Dilatation of the lateral ventricles was assessed by computing the ventricle-brain ratio (VBR) from the CT scan. The VBR was inversely correlated with the 'Bayley Mental Scale' score. Two thirds of the sample were reevaluated after 1 year; there was a significant decrease in VBR, but mental quotient was unchanged. These findings are in agreement with studies on older children in that the prognosis for cognitive functioning in hydrocephalic children is affected by brain injury. A correlation between brain mass and intelligence has been reported in older children with uncomplicated hydrocephalus, but not in groups with mixed etiology.