Pediatric hydrocephalus outcome

see Hydrocephalus Outcome Questionnaire

If left untreated, most cases are lethal 1).

With present-day standard of care, most patients with HC will survive; however, death from hydrocephalus still exists.

Some of these causes may be avoidable through early detection of symptoms. Guidelines to patients, families, and primary caregivers should be emphasized 2).

The rate of shunt malfunction death has decreased over time. It is reasonable to attribute part of this decline to continued improvements in diagnostic and therapeutic techniques and to the use of surveillance scans to identify asymptomatic patients with shunt failure. However, the majority of this decline is due to two additional factors: (1) increased nursing staff and (2) effective patient/family education 3).

Adults treated for hydrocephalus in childhood require a life-long follow-up. Late mortality is low but not null, morbidity is high, and many patients require shunt surgery during adulthood. The transition from child to adult neurosurgery needs to be organized for these vulnerable patients 4).

1)
LAURENCE KM, COATES S. The natural history of hydrocephalus. Detailed analysis of 182 unoperated cases. Arch Dis Child. 1962 Aug;37:345-62. PubMed PMID: 14462827; PubMed Central PMCID: PMC2012878.
2)
Iskandar BJ, Tubbs S, Mapstone TB, Grabb PA, Bartolucci AA, Oakes WJ. Death in shunted hydrocephalic children in the 1990s. Pediatr Neurosurg. 1998 Apr;28(4):173-6. PubMed PMID: 9732242.
3)
Acakpo-Satchivi L, Shannon CN, Tubbs RS, Wellons JC 3rd, Blount JP, Iskandar BJ, Oakes WJ. Death in shunted hydrocephalic children: a follow-up study. Childs Nerv Syst. 2008 Feb;24(2):197-201. Epub 2007 Jun 27. PubMed PMID: 17594102.
4)
Vinchon M, Baroncini M, Delestret I. Adult outcome of pediatric hydrocephalus. Childs Nerv Syst. 2012 Jun;28(6):847-54. doi: 10.1007/s00381-012-1723-y. Epub 2012 Feb 19. PubMed PMID: 22349961; PubMed Central PMCID: PMC3360844.