Study of clinico-etiological profile and outcome of operated children of hydrocephalus in a tertiary care hospital

Abstract

Background: Hydrocephalus is a prevalent neuro-pediatric condition associated with considerable morbidity and mortality. Ventriculo-peritoneal (VP) shunt placement remains the standard treatment, although complications are frequent. This study evaluated the clinico-etiological profile and outcomes of children with hydrocephalus who underwent VP shunt surgery at a tertiary care hospital.

Methods: A bidirectional study was conducted involving 52 children aged 1 month to 12 years who underwent VP shunt surgery. Demographics, clinical features, etiologies, imaging, surgical procedures, and outcomes were analyzed. Follow-up assessments were performed at 3, 6, 12, and 24 months to evaluate complications, clinical outcomes, and psychosocial impact.

Results: A female predominance was observed (male to female ratio=0.8:1), with most children presenting at a mean age of 3.7 years. Seizures (55.8%) and progressive head enlargement (28.8%) were the most common presenting features. Acquired hydrocephalus (65.3%) was more prevalent than congenital hydrocephalus (32.6%), with tuberculous meningitis identified as the leading cause (50%). Dandy-Walker malformation was the most frequent congenital etiology (21.1%). Communicating hydrocephalus was the predominant type (80.8%). The most common complications were shunt blockage (51.9%), infection (40.4%), and migration (40.4%). Overall mortality was 34.6%.

Conclusions: In this cohort, pediatric hydrocephalus was predominantly acquired, with tuberculous meningitis as the leading cause. VP shunt surgery improved survival but was associated with high rates of complications and revisions, particularly among younger children and those with tuberculous meningitis. Long-term morbidity included growth impairment and psychosocial challenges. Early diagnosis, regular follow-up, and prompt management of shunt complications are essential for improving outcomes.