Magnitude of Hydrocephalus in Neonates: Its Surgical Management and Complications
Keywords:
Hydrocephalus, congenital, Myelomeningocele, Management, Ventriculo- peritoneal shunting, complications, Wound infection, Spina bifidaAbstract
Abstract: Objective: : To determine magnitude of congenital or acquired hydrocephalus and its possible management and complications.
Materials and Methods: This Hospital based Retrospective observational study was conducted in department of pediatric surgery King Edward medical university / Mayo hospital Lahore from January 2021 to March 2022.
All patients presented from neonatal life till 3 months of age with hydrocephalus due to congenital or acquired reasons were included in this study. There were 55 male and 28 female patients with male to female ratio of 1.9:1. A detailed Proforma was made giving patients information, associated congenital or acquired anomaly and surgical management of hydrocephalus. All patients were operated on elective operation theatre list. Post-operative complications were noticed on admission files and addressed.
Results: During the study period, 83(n=1) patients with hydrocephalus were admitted in department of pediatric surgery Mayo hospital Lahore. Among these patients, 56(67.5%) patients have hydrocephalus associated with myelomeningocele while 10(12%) patients with encephalocele. 11(13.3%) patients showed hydrocephalus due to post tuberculosis meningitis while 3(3.6%) patients with Arnold chiari 2 malformation. 1(1.2%) patients presented with hydrocephalus due to Congenital obstruction of cerebral aqueduct while 2(2.4%) with Intracranial hemorrhage.ventriculoperitoneal shunting was done in 55(66.3%) patients to treat hydrocephalus. Conservative management of hydrocephalus was done in 24(28.9%) patients while in 4(4.8%) patients ventricular taping was done. Wound infection was major post-operative complication and was noted in in 13 (15.7%) patients.
Conclusion: Ventriculo peritoneal shunting is main treatment modality for obstructed hydrocephalus. Major complication of ventriculo pertoneal shunting is infection which can be addressed by proper prophylactic antibiotics as well as sterile environment of operation theatre.
