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[Surgical treatment of hydrocephalus in children. I. Clinical development and mortality]
Insights
Ventriculoperitoneal shunts effectively treated pediatric hydrocephalus, with 88.2% success at 18 months. Survivors showed improved neuromotor development, though meningitis posed a significant mortality risk.
Area of Science:
- Pediatric Neurosurgery
- Neurology
- Medical Device Technology
Context:
- Hydrocephalus in children presents significant challenges.
- Congenital malformations, meningitis, and tumors are primary causes.
- Surgical intervention is crucial for managing increased intracranial pressure.
Purpose:
- To analyze the clinical outcomes and mortality rates of surgical hydrocephalus treatments in children.
- To evaluate the efficacy of different shunting techniques, including ventriculoperitoneal shunts.
- To assess the long-term neuromotor development in pediatric hydrocephalus survivors.
Summary:
- A study of 57 children with hydrocephalus (1970-1980) examined surgical treatments.
- Ventriculoperitoneal shunts demonstrated high success rates (89.4% immediate, 88.2% at 18 months).
- Operative mortality was 25.7%, with an overall mortality of 34%, often linked to meningitis.
Impact:
- Ventriculoperitoneal shunts are a viable and effective treatment for pediatric hydrocephalus.
- Early intervention and appropriate shunting can lead to improved neuromotor outcomes.
- Meningitis remains a critical factor influencing mortality in treated hydrocephalus patients.
Abstract:
The authors analized the clinical evolution and the mortality of fifty seven children with hydrocephalus due to congenital malformation (41.1%), meningitis (36.8%) and tumors (21.1%), that were submitted to surgical treatment for hydrocephalus, from 1970 to 1980. Insertions of ventriculostomy reservoir and of external ventricular drainage were satisfactory used to control the expanding hydrocephalus in children with meningitis, that wait insertion of the valve. The use of hypothalamic ventriculostomy with catheter has showed satisfactory results in the treatment of children with hydrocephalus due to non inflammatory origin. Ventriculoatrial shunts were utilized in few cases but were useful in the treatment of hydrocephalus in children. The operative mortality rate was 25.7%. Ventriculoperitoneal shunts showed good results in the treatment of hydrocephalus in 89.4% of the cases in the immediate post-operative time and this number drop to 88.2% at the eighteen post-operative month. The overall mortality rate was 34%. At the end of the third post-operative month 27.3% of the survivors of the children with hydrocephalus due to congenital malformation and meningitis submitted to ventriculoperitoneal shunts showed normal neuromotor development and at the end of the second post-operative year this number increased to 50%. The operative mortality rate in this group was 25% and the majority of death occurred due to meningitis.