Prognostic factors affecting the surgical outcome of secondary hydrocephalus in infants

Abstract

Background: Acquired Hydrocephalus can develop at birth or in adulthood. It has many etiologies like obstruction by Tumors, inflammatory and infective lesions like meningioencephalitis and cerebral abscess. It may result from Hemorrhage like parenchymal hemorrhage, intra-ventricular hemorrhage, germinal matrix hemorrhage(GMH). GMH is the leading cause of acquired infantile hydrocephalus in preterms. But still the main causes of secondary hydrocephalus in the infantile age groups post-meningetic and post hemorrhagic. Aim: the aim of this study is to evaluate the different prognostic factors affecting the clinical and surgical outcome in cases of secondary hydrocephalus in infants. Methods: This is a prospective study conducted on 30 non-consecutive cases with secondary hydrocephalus who underwent surgery by variable surgical procedures at Benha University Hospital from March 2022 to June 2023. Results: The mean age of the included patients was 11.43 months. The distribution of underlying pathology of studied cases was (Post-meningetic 80%, Post-hemorrhagic 13.3%, Posttumor 6.7%). Cases were followed up for 6-12 months. There was reported incidence of favorable clinical and surgical outcome of 60 % of cases with no need for any surgical procedure and adverse outcome in 40%. Conclusion: Secondary hydrocephalus in a premature baby, with LBW, especially if admitted to NICU for more than 1 month, with presence of systemic sepsis and CSF infection by G-ve bacilli especially with frequent CSF tapping had the worst outcome. While maturity and normal birth weight without NICU admission, and absence of sepsis with negative CSF culture predicting a favorable clinical and surgical outcome.