Using ′Catheter ΰ fentes′ for management of childhood hydrocephalus: A prospective study of ninety-six cases

Abstract

Objective:To evaluate the management of childhood hydrocephalus using the ‘catheter à fentes’ as a ventriculoperitoneal shunt.Materials and Methods:A prospective study from January 2003 to January 2004 was carried out in the Neurosurgery Department of the National Hospital Niamey (Niger-Republic). Ninety-six infants with hydrocephalus, between the ages of 1 to 22 months were treated with ‘catheter à fentes’ as a ventriculoperitoneal shunt.Results:Ninety-six infants with hydrocephalus, between the ages of 1 and 22 months were included in this study, over a period of 31 months; 53% of the infants were females. The symptoms evolved over three months in 89.55% of the cases (n = 85). Hydrocephalus was post-infective in 51% of the cases, associated with spina bifida in 32% of the cases, neonatal bleeding in 7.2% of the cases; brain abnormalities were found in 6.2%, and tumor in 3.1% of the cases. The head circumference was greater than 2SD in all cases; 87.53% of the infants had psychomotor retardation (less than 80 QD according to the Lezine score). Ventricular dilation was triventricular in 17.70% and tetra ventricular in 82.29% of the cases. ‘Catheter à fentes’ models of high pressure, medium pressure, and low pressure were used. Hydrodynamic complications (hyperdrainage, obstruction, underdrainage) occurred in 7.9% of the cases, and these were handled with simple observation in follow-up clinics. The average regression of head circumference three months postoperatively, for all the three models of ‘catheter à fentes,’ was 3.73 cm.Conclusion:This study shows that the usage of ‘catheter à fentes’ for treatment of childhood hydrocephalus gives satisfactory results.

History and Current State of Global Neurosurgery in Sub-Saharan Africa

“…Pediatric neurosurgery centers across the continent have contributed to developing new equipment, techniques, and improved patient outcomes. For instance, the University of Zimbabwe team developed the Harare shunt, and the Nigerien team developed the Niamey slit catheter (10). Both devices have changed hydrocephalus's management.…”

“…The Ugandan team contributed to developing endoscopic third ventriculostomy with choroid plexus cauterization -an alternative to shunt treatment of hydrocephalus. Like Uganda, Niger has established itself as regional reference centers for the neuroendoscopic management of hydrocephalus (10).Neurotraumatology, despite the accessibility of surgical management, remains an orphan of resuscitation means, which are not always available in many countries like pediatric neurosurgery; neuro-oncology practice is booming in several SSA centers. These include Abidjan, Ouagadougou, and Dakar, where the skull base surgery and endonasal endoscopic approach for pituitary tumors are now widely used (7).…”

Improving Brain Tumor Research in Resource-Limited Countries: A Review of the Literature Focusing on West Africa

“…These are facts from HBCRs as opposed to population-based registries, which cover only 7.2% of the total population [ 13 ]. In Ghana, 30 neurological tumors were seen in one hospital within a period of two years, while 3.1% hydrocephalus cases in The Republic of Niger were found to be as a result of tumors [ 14 - 15 ].…”