Hydrocephalus in the Pediatric Population in the Tropic Co-morbidity Impact at CHU in Conakry

Abstract

Hydrocephalus is a pathologic dilatation of the ventricles which occurs progressively when provoked by a disruption in the production, circulation and reabsorption of the cerebrospinal fluid (CSF). This study aims to report the impact of co-morbidities on the surgical outcome of pediatric hydrocephalus in Guinea. It was a retrospective clinical study carried out at Friendship hospital, Sino-Guinea of Kipe, for 13 months. 107 patients were scheduled for hydrocephalus surgery. The incidence of Hydrocephalus was 8.20% related to the 107 patients admitted during our period of study. The main comorbitdies encounter were, anemia (73 cases), respiratory infection (38 cases) malaria (malaria 37 cases), malnutrition (14 cases), deshydratation (11 cases), candidosis (7 cases), respiratory detress (6 cases), cutaneous infections (6 cases), convulsion (6 cases), meningitis (5 cases), otorhinolaryngology infection (2 cases), septicemia (2 cases) tardive neonatal infection (91 cases). The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. Hydrocephalus is a commonly encountered pediatric pathology in sub-Saharan Africa where it constitutes a major public health concern. The etiologies are still dominated by neonatal infections. The treatment is essentially a surgical approach.

Endoscopic Third Ventriculostomy with or without Choroid Plexus Coagulation for Treatment of Hydrocephalus in Guinea: Analysis of 76 Cases in the Department of Neurosurgery of Kipe, Conakry

“…Whether or not the death is directly linked to the surgical procedure or external factors like other medical conditions and the difficult access to a hospital from remote areas of the country remains unknown. A previous report in the same hospital found a mortality of 41% for shunt therapy [1].…”

“…Shunt dependency and associated morbidity is a significant problem in low-income countries like Guinea, as the patients do not have easy access to emergent neurosurgical evaluation and treatment in case of dysfunction or infection [1]. Therefore, finding a way to treat these infants without the use of a shunt is desirable.…”

“…More than half of the patients included in the series were operated in the first 2 years of the study period. During this period, the program was well funded, the patients were actively recruited from all neonatal care department in the country with massive communications to counteract traditional cultural assumptions about extreme macrocrania in infants [1]. These patients were investigated and treated for free and followed up appropriately in the postoperative period.…”

“…Hydrocephalus is the most frequent cause of referral in Pediatric Neurosurgery in Guinea, and most cases of hydrocephalus in children are congenital or acquired during the early childhood period [1]. The ventriculoperitoneal shunt is the traditional hydrocephalus treatment and has shown good outcomes in terms of survival and neurocognitive development [2].…”