Initial brain CT scan and shunting outcomes in children with hydrocephalus
Keywords:
hydrocephalus, brain CT scan, shunting, ventricle dilatation
Abstract
Background Hydrocephalus is one of the most common clinicalconditions affecting the central nervous system, with a congenital
hydrocephalus incidence of 3-4 per 1000 births. Incidence of
acquired types of hydrocephalus is unknown. Brain computerised
tomography (CT) scan can be used to assess the size of ventricles
and other structures. Shunting has long been performed to
alleviate hydrocephalus. Shunting has dramatically changed the
outlook of children with hydrocephalus, with many of them having
normal life expectancies and attaining normal intelligence.
Objective To determine the outcomes of shunting in children
with hydrocephalus based on initial brain CT scan.
Methods We performed a cross-sectional study in Dr. Kariadi
Hospital. Initial brain CT scan data were collected from the
medical records of children admitted to the Neurosurgery Ward
for ventriculoperitoneal (VP) shunt surgery from January 2009
to December 2010. We studied the brain CT scan findings before
VP shunt surgery and the outcomes of the children after VP shunt
surgery. Radiological findings were determined by a radiologist
responsible at that time.
Results This study consisted of 30 subjects, 19 boys and 11
girls. Initial brain CT scans to assess disease severity revealed the
fo llowing conditions: lateral ventricle dilatation in 7 subjects,
lateral and third ventricle dilatation in 16 subjects, and lateral,
third and fourth ventricle dilatation in 7 subjects. After VP
shunt surgery, 3 subjects in the lateral, third and fourth ventricle
dilatation category died. They were grouped according to their
condition. Group 1 consisted of subjects with only lateral ventricle
dilatation and subjects with lateral and third ventricle dilatation
(23 subjects), while group 2 consisted of subjects with lateral,
third and fourth ventricle dilatation (7 subjects). More survivors
were found in group 1 than those in group 2.
Conclusion Less severe initial brain CT scan findings are
associated with better shunting outcomes children with
hydrocephalus.
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Th omas H. Milhorat, ed. Teratology Vol. 9. Baltimore:
Williams and Wilkins Co; 1972: p. 237. DOI: 10.1002/
tera.1420090116
3. Welch K. The intracranial pressure in infants.] Neuro Surg.
1980;52:693-9.
4. Colak A, Albright AL, Pollack IF. Follow-up of children with
shunted hydrocephalus. Pediatr Neurosurg. 1997;27:208-10.
5. Game E, Loane M, Addor MC, Boyd PA, Barisic I, Dolk H.
Congenital hydrocephalus - prevalence, prenatal diagnosis
and outcome of pregnancy in four European regions. Eur J
Paediatr Neural. 2010;14:150-5.
6. Khattak A, Haider A. Treatment of congenital hydrocephalus.
JPMI. 2003; 17 :11-3.
7. Myrianthopuolus NC, Kurland LT. Present concept of the
epidemiology and genetics of hydrocephalus. Disord Dev
Nervous Syst. 1961;2:187-202.
8. Dandy WE. Experimental hydrocephalus. Ann Surg.
1919;70: 129-42.
9. Oi S, Di Rocco C. Proposal of "evolution theory in
cer ebrospinal fluid dynamics" and minor pathway
hydrocephalus in developing immature brain. Childs Nerv
Syst. 2006;22:662-9.
10. Laurence, Russell DS. Observation on the pathology of
hydroceph alus. Medical research council special report series.
London: His Majesty's Stationery Office; 1994. p. 112- 13.
11. O'Brien MS, Harris ME. Long-term results in the treatment
of hydrocephalus. Neurosurg Clin N Am. 1993;4:625 -32.
12. Mater A, Shroff M, Farsi S, Drake J. Goldman RD. Test
characteristics ofneuroimaging in the emergency department
evaluation of children for cerebrosp inal fluid shunt
malfunction . CJEM. 2008;10:13 1-5 .
Published
2013-08-31
How to Cite
1.
Utami A, Putranti A, Nency Y, Sudijanto E. Initial brain CT scan and shunting outcomes in children with hydrocephalus. PI [Internet]. 31Aug.2013 [cited 22Nov.2024];53(4):200-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/281
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Received 2016-08-21
Accepted 2016-08-21
Published 2013-08-31
Accepted 2016-08-21
Published 2013-08-31
