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[Clinico-epidemiologic study of infantile hydrocephalus in Japan]
T Negoro1, K Watanabe, S Nakashima
1Department of Pediatrics, Nagoya.
Insights
A 1988 Japanese survey estimated 800 new cases of congenital hydrocephalus annually, affecting 0.58 per 1,000 live births. Preterm infants faced higher risks, neurological impairment, and mortality from hydrocephalus.
Area of Science:
- Epidemiology
- Pediatrics
- Neurology
Context:
- A nationwide survey in Japan investigated congenital hydrocephalus in 1988.
- This included secondary hydrocephalus within one year of birth.
- Data from 3,200-3,500 treated patients and 800 new cases were analyzed.
Purpose:
- To compare clinico-epidemiologic features of congenital hydrocephalus in term versus preterm infants.
- To analyze trends in infantile hydrocephalus in Japan over time.
- To investigate features of intractable hydrocephalus.
Summary:
- Congenital hydrocephalus affects 0.58 per 1,000 live births in Japan.
- Term infants had higher rates of primary hydrocephalus and Arnold-Chiari malformation, while preterm infants had higher rates secondary to intracranial hemorrhage.
- Preterm infants experienced greater neurological impairment and mortality.
- Trends show increasing preterm hydrocephalus, rising cases from intracranial hemorrhage, decreasing cases from infection, and reduced shunt malfunction rates.
Impact:
- Provides crucial epidemiological data on congenital hydrocephalus in Japan.
- Highlights disparities in etiology, severity, and outcomes between term and preterm infants.
- Informs clinical management and public health strategies for infantile hydrocephalus.
Abstract:
A nation-wide survey on congenital hydrocephalus, including secondary hydrocephalus occurring within one year after birth, was carried out in 1988. The number of patients with congenital hydrocephalus treated during the previous one year was estimated to be 3,200-3,500 throughout Japan. The number of new cases of this disease which occurred during the year was calculated to be 800. This indicates a rate of 0.58 per 1,000 live births. Clinico-epidemiologic features were compared with regard to three subjects listed below. (1) The difference between the epidemiologic profile of term and preterm infants with hydrocephalus was investigated. As for etiology, the incidences of primary hydrocephalus and hydrocephalus complicated by Arnold-Chiari malformation type II and meningocele were significantly higher in term infants than in preterm infants. It was estimated that about 30% of the hydrocephalus in preterm infants and only 7.7% in term infants occurred as a consequence of intracranial hemorrhage. The degree of neurological impairment and the mortality rate were higher in preterm infants than term infants. (2) The changing panorama of infantile hydrocephalus in Japan was investigated comparing the epidemiologic data of four groups according to the birth year. As for pregnancy period, preterm infants with hydrocephalus were gradually increasing recently. Hydrocephalus secondary to intracranial hemorrhage was increasing and that secondary to intracranial infection was decreasing. The rate of shunt malfunction was decreasing significantly. (3) Clinico-epidemiologic features of intractable hydrocephalus based on the diagnostic criteria of the research committee was investigated comparing intractable with non-intractable groups.(ABSTRACT TRUNCATED AT 250 WORDS)