home : about us : ahead of print : current issue : archives search instructions : subscriptionLogin 
Users online: 1606      Small font sizeDefault font sizeIncrease font size Print this page Email this page
 ORIGINAL ARTICLE
Year : 2011  |  Volume : 6  |  Issue : 1  |  Page : 4-12

Evaluation of functional outcomes in congenital hydrocephalus


1 Department of Neurosurgery, Advanced Neuro Science Institute, BGS Global Hospital, Bangalore, India
2 Department of Neuropsychology, NIMHANS, Bangalore, India

Correspondence Address:
N K Venkataramana
Department of Neurosurgery, Advanced Neuroscience Institute, BGS Global Hospital, BGS Health and Education City, No. 67, Uttarahalli Road, Kengeri, Bangalore - 560 060
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.84399

Rights and Permissions

Aim: The long term outcomes of congenital hydrocephalus are still not clearly known despite it being a common clinical condition. Several clinical, radiological factors were correlated to predict the functional outcomes. This study aimed to correlate the clinical, radiological parameters with the regional functional outcomes of the brain. Materials and Methods: Children with congenital hydrocephalus were divided into Group A with hydrocephalus alone and Group B hydrocephalus with spina bifida. Ventriculoperitoneal shunt surgery was performed by the same surgeon. CT scans and neuropsychological assessments were performed before and serially after the shunt. The clinical and the radiological findings were correlated with the developmental levels during the follow-up. Results: There were 25 children in Group A and 15 children in Group B; 72% in Group A and 93% in Group B were less than 6 months of age at the time of treatment. Forty percent in Group A and 92% in Group B had the signs of hydrocephalus at admission. Cerebrospinal fluid (CSF) diversion results in the reduction in ventricular dilatation and corresponding increase in the cortical mantle thickness. The ventricular size and the cortical mantle thickness were measured serially and correlated with the development in the neuropsychological function. In this study, 80% in Group B reached near normal development in comparison to 33% in Group A. We have noticed a significant correlation in the increase in the regional cortical mantle thickness with corresponding improvement in the functional development. This clearly ratifies the improvement in the frontal and parietal areas having their distinctive effect on the functional development of the child. Conclusion: Early CSF diversion and timely intervention seems to benefit functional recovery. It is interesting to note that reconstitution of cortical mantle in different areas of the brain showing corresponding improvement in their respective areas. Large ventricles (head circumference more than 50 cm) recurrent subdural collections and repeated shunt obstructions have a bad influence on the long-term outcome. Unlike the previous belief the children with myelomeningocele can have equal benefit in terms of neuropsychological development after the shunt surgery.






[FULL TEXT] [PDF]*


        
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed4868    
    Printed166    
    Emailed1    
    PDF Downloaded238    
    Comments [Add]    
    Cited by others 3    

Recommend this journal