Neurodevelopmental long-term outcome in children with hydrocephalus requiring neonatal surgical treatment

Abstract

Purpose: To assess long-term neurodevelopmental outcome in children with hydrocephalus requiring neurosurgical treatment during the neonatal period.

Methods: This prospective longitudinal population-based study included 43 children with neonatal shunted hydrocephalus. The 43 children were prospectively reviewed in the presence of their parents at the outpatient clinic. Cognitive and motor outcomes were assessed respectively using different Wechsler scales according to age and Gross Motor Function Classification System (GMFCS). Postoperative MRI was routinely performed.

Results: The mean gestational age at birth of the 43 consecutive children with neonatal hydrocephalus (sex ratio M/F: 1.39) was 34.5±5.4 weeks of gestation. At mean follow-up of 10.4±4 years, mean total IQ was 73±27.7, with equivalent results in mean verbal and mean performance IQ. Of the 33 children with IQ evaluation, 18 presented an IQ≥85 (41.9%). Efficiency in walking without a mobility device (GMFCS≤2) was obtained in 37 children (86%). Only severity of postoperative ventricular dilation was significantly associated with unfavorable outcome (Evans index>0.37; odds ratio: 0.16, P=0.03).

Conclusion: This information could be provided to those families concerned who often experience anxiety when multi-disciplinary management of neonatal hydrocephalus is required.

Keywords: Cognitive deficit; Dilatation ventriculaire; Déficit cognitif; Dérivation ventriculo-péritonéale; Hydrocephalus; Hydrocéphalie; Intellectual performance; Long-term follow-up; Newborn; Nouveau-né; Performances intellectuelles; Suivi à long terme; Ventricular dilatation; Ventriculo-peritoneal shunt; Ventriculocisternostomy; Ventriculocysternostomie.