Hydrocephalus in Infancy and Childhood: Diagnosis and Indication for Operation

Mr, Gaab; Wt, Koos

doi:10.1055/s-2008-1052363

Cited by 13 publications

(6 citation statements)

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“…Advanced understanding was accompanied by new concepts in the management of hydrocephalus [4,9,12,14] and by improvement in shunt technology [5,11,22,23,25]. Based on his interpretations of the pathophysiology of hydrocephalus S. Hakim searched for a valve adaptable to changing hydrodynamic conditions [11].…”

Section: Discussionmentioning

confidence: 99%

Clinical experience with a new pressure-adjustable shunt valve

1995

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The pressure-adjustable valve system Codman Medos allows valve pressure adjustment in 18 steps between 30 and 200 mm H2O. A series of 90 patients, 15 children and 75 adults, who were shunted with this new programmable valve, is reported. Indication for shunt insertion were various types of hydrocephalus in 79 cases, malfunction of a medium pressure membrane valve shunt system in 9 cases and an arachnoid cyst and pseudotumour each in one case. The valve pressure was programmed prior to insertion to 200 mm H2O in the adults and according to age in children and was modified postoperatively according to the clinical course. Underdrainage with subdural fluid collections appearing in 5 patients could be managed by valve pressure adjustment alone in 2 cases. One malfunctioning of the valve mechanism was due to mechanical obstruction. At the time of follow-up, 7 to 29 months after operation, outcome was excellent in 64 patients, good with marked improvement but residual symptoms in 19 patients and unchanged in 7 patients. The possibility of adjusting the valve pressure to the patient's demands was frequently used in children and adult normal pressure hydrocephalus patients with satisfying clinical results.

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Section: Discussionmentioning

confidence: 99%

Clinical experience with a new pressure-adjustable shunt valve

1995

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“…A non-invasive intracranial pressure (ICP) measurement was performed in all cases, using a Ladd pressure transducer attached to the fontanelle with stickingplaster (Gaab and Koos 1984). We considered ICP to be elevated if its value exceeded lOcm H~O , measured while the child was motionless.…”

Section: Methodsmentioning

confidence: 99%

“…At present no form of intervention is of certain benefit in the treatment of these children, the majority of whom had an unfavourable neurodevelopmental outcome. Other examinations, such as determination of the intracranial reserve space (Gaab and Koos 1984), could be helpful in identifying children who need surgical intervention. Again, it should be stressed that serial follow-up sonograms are needed to detect the progression of arrested hydrocephalus to progressive hypertensive hydrocephalus.…”

Section: )mentioning

confidence: 99%

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Cranial Ultrasonography In The Evaluation Of Macrocrania In Infancy

Bošjak¹,

Bešenski²,

Marina³

et al. 1989

Develop Med Child Neuro

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SUMMARY Cranial ultrasonography was used in the initial evaluation of 40 infants with macrocrania. Three of the infants had normal findings. The other 37 had evidence of various types of abnormality: intraventricular obstructive hydrocephalus, external hydrocephalus, arrested hydrocephalus with atrophy, or mild ventriculomegaly. All the infants were given neurological and developmental examinations at the time of presentation and were followed up for one year. Sonograms and head‐circumference and intracranial pressure measurements were done at intervals, according to the initial ultrasound findings and the clinical status of the children. Neurodevelopmental outcome was related to the type of abnormality. The majority of children with external hydrocephalus were neurodevelopmentally normal at follow‐up. In contrast, those with obstructive or arrested hydrocephalus had unfavourable outcomes, which may be related to the significant perinatal insult causing the hydrocephalus. CT confirmation was available for 16 of the infants. RÉSUMÉ Echographies craniennes dans l'évaluation de macrocéphalie chez le nourrisson L'échographie cranienne fut utilisée dans l'évaluation initiale de 40 nourrissons avec macrocéphalie. Les données cliniques étaient normales dans trois cas. Dans les 37 autres cas, il existait des types variés d'anomalies: hydrocéphalie intraventriculaire non communicante, hydrocéphalie périphérique, hydrocéphalie stabilisée avec atrophie, ou ventriculomégalie modérée. Tous les nourrissons bénéficiérent d'examens neurologiques et développementaux au moment de l'évaluation initiale et furent suivis durant un an. Des échographies, mesures du tour de tête et de la pression intracranienne furent effectuées régulièrement, en fonction des données de l'échographie initiale et de l'état clinique des enfants. Le devenir neuro‐développemental fut relié au type d'anomalies. La majorité des enfants avec hydrocéphalie périphérique eurent un développement neurologique normal au suivi. En revanche, le devenir ne fut pas favorable pour les hydrocéphalies non communicantes ou stabilisées, ce qui pourrait être reliè aux dommages périnataux marqués ayant provoqué l'hydrocéphalie. Une confirmation par scanners existait pour 16 des nourrissons. ZUSAMMENFASSUNG Cranielle Ultrasonographie zur Beurteilung der Makrokranie im Kindesalter Bei 40 Kindern mit Makrokranie wurde zur ersten Beurteilung die cranielle Ultrasonographie durchgeführt. Drei der Kinder hatten normale Befunde. Die anderen 37 hatten verschiedene abnorme Befunde: intraventrikulären, obstruktiven Hydrocephalus, externen Hydrocephalus, zum Stillstand gekommener Hydrocephalus mit Atrophie oder leichte Ventrikulomegalie. Alle Kinder wurden bei der Aufnahme genau neurologisch und im Hinblick auf ihre Entwicklung untersucht und über ein Jahr kontrolliert. Je nach anfänglichem Ultraschallbefund und klinischem Zustand der Kinder wurden in Intervallen Sonogramme und Messungen des Kopfumfangs und des intracraniellen Druckes vorgenommen. Der Endbefund der neurologischen Entwickl...

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“…Hydrocephalus in children, if untreated, causes developmental disorders, mental deficiencies and shortened life expectancy in addition to blindness and other neurological deficits as a result of cerebral injury due to distention of brain tissue (3).…”

Section: Introductionmentioning

confidence: 99%

Ventriculoperitoneal shunt surgery and shunt infections in children with non-tumour hydrocephalus at the Kenyatta National Hospital, Nairobi

Mwang'ombe¹,

Omulo²

2009

E Af Med Jrnl

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Objective: To study infections complicating ventriculoperitoneal (VP) shunt surgery in children with non-tumour hydrocephalus at the Kenyatta National Hospital, Nairobi. Design: A retrospective survey. Setting: Kenyatta National Hospital, Nairobi between January 1982 and December 1991. Subjects: Three hundred and forty five patients who underwent V-P shunt placement for non-tumour hydrocephalus. Results: Three hundred and forty five patients underwent V-P shunt placement for nontumour hydrocephalus. There were 107 infection episodes involving 85 patients. The ages of these patients ranged from three months to 12 years. Most of the patients had congenital hydrocephalus. The infection rate was high (24.6%) although comparable to infection rates reported for clean surgery in the hospital. Fever, septic wounds and features of shunt malfunction were the main presenting features. Bacteriological studies confirmed Staphylococcus aureus and coagulase negative staphylococci as the two most commonly isolated micro-organisms. Conclusion: This study emphasises need to reduce infection rate in ventriculoperitoneal shunt surgery at the Kenyatta National Hospital. Definitive surgical treatment for hydrocephalus was in most cases delayed and this problem was also observed during revision of infected shunts. Late presentation was often due to ignorance and the fact that many patients went for traditional forms of treatment first before going to hospital.

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Hydrocephalus in Infancy and Childhood: Diagnosis and Indication for Operation

Cited by 13 publications

References 0 publications

Clinical experience with a new pressure-adjustable shunt valve

Clinical experience with a new pressure-adjustable shunt valve

Cranial Ultrasonography In The Evaluation Of Macrocrania In Infancy

Ventriculoperitoneal shunt surgery and shunt infections in children with non-tumour hydrocephalus at the Kenyatta National Hospital, Nairobi

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