Initial brain CT scan and shunting outcomes in children with hydrocephalus

Background Hydrocephalus is one of the most common clinical conditions affecting the central nervous system, with a congenital hydrocephalus incidence of 3-4 per 1000 births. Incidence of acquired types of hydrocephalus is unknown. Brain computerised tomography (CT) scan can be used to assess the size of ventricles and other structures. Shunting has long been performed to alleviate hydrocephalus. Shunting has dramatically changed the outlook of children with hydrocephalus, with many of them having normal life expectancies and attaining normal intelligence. Objective To determine the outcomes of shunting in children with hydrocephalus based on initial brain CT scan, Methods We performed a cross-sectional study in Dr. Kariadi Hospital. Initial brain CT scan data were collected from the medical records of children admitted to the Neurosurgery Ward for ventriculoperitoneal (VP) shunt surgery from January 2009 to December 2010. We studied the brain CT scan findings before VP shunt surgery and the outcomes of the children after VP shunt surgery. Radiological findings were determined by a radiologist responsible at that time. Results This study consisted of 30 subjects, 19 boys and 11 girls. Initial brain CT scans to assess disease severity revealed the following conditions: lateral ventricle dilatation in 7 subjects, lateral and third ventricle dilatation in 16 subjects, and lateral, third and fourth ventricle dilatation in 7 subjects. After VP shunt surgery, 3 subjects in the lateral, third and fourth ventricle dilatation category died. They were grouped according to their condition, Group I consisted of subjects with only lateral ventricle dilatation and subjects with lateral and third ventricle dilatation (23 subjects), while group 2 consisted of subjects with lateral, third and fourth ventricle dilatation (7 subjects). More survivors were found in group 1 than those in group 2. Conclusion Less severe initial brain CT scan findings are associated with better shunting outcomes children with hydrocephalus.