Psychomotor Performance in Children Operated for Hydrocephalus: About 79 Cases

Abstract

Introduction: Ventricle enlargement is characteristic of hydrocephalus and responsible of brain compression including ischemic disorders and alterations of the myelinisation. Delayed management of children hydrocephalus could induce definitive psychomotor impairment. Our aim was to assess children that have been operated for hydrocephalus in psychomotor field before and after operation. Patients and Methods: It was a retrospective, cross sectional and analytical survey. The study was conducted on children operated from 2003 through 2009. These children were reevaluated in 2013. Sometimes, clinical data were obtained from their parents or relatives. The Denver test was used for final neurological evaluation. Results: From 2003 through 2009, 357 children were managed for hydrocephalus. Seventy nine cases were included for this study. In 35 cases (44.33%) families’ monthly incomes were below the minimum salary fixed by the government. Prior to surgical procedure, 57.2% of these children had macrocrania (>3 SD). Only three children (3.79%) underwent surgery within one month after admission. With a medium follow up of 7.8 years, 41 of operated children (51.9%) are still alive and 19 (24.05%) were symptomatic psychomotor delay were identified in 18 cases, whereas major functions impairments were present in 14 cases. Twenty three (56.1%) were attending schools. Conclusion: In this report, difficulties in management of children with hydrocephalus could be responsible of psychomotor impairments. More effort must be done regarding the initial evaluation, surgical management and social integration.