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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 21, No. 1, 2016, pp. 36-44
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Bioline Code: js16004
Full paper language: English
Document type: Research Article
Document available free of charge
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East and Central African Journal of Surgery, Vol. 21, No. 1, 2016, pp. 36-44
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Management and Functional Outcome of Childhood Hydrocephalus at the Kenyatta National Hospital.
Nganga, H K; Musau, C K & Mbuthia, J M
Abstract
Background: Hydrocephalus is a pathological condition caused by abnormalities of
production or absorption of CSF in the brain. The goal of this study was to evaluate the
current management and outcome of children (aged 13 years and below) who were treated
for hydrocephalus in a single institution in Kenya.
Methods: A retrospective analysis was conducted on 200 childrenwho were admitted to the
neurosurgical unit at the Kenyatta National Hospital and diagnosed with hydrocephalus
between January 2000 and April 2013. The records were analyzed for demographic
characteristics, clinical presentation and management variables. Outcome was assessed
according to the Glasgow Outcome Scale (GOS) score at the time of discharge from hospital.
Results: There were 95 male (47.5%) and 105 female (52.5%) patients. The median age
was 3.5 months. 16.5% had associated congenital anomalies, the commonest being spina
bifida (18.2%) and dandy walker cyst (18.2%). 162 (81%) of the patients had surgical
intervention which included shunts (92.6%), drains (0.6%), therapeutic aspiration (0.6%)
and endoscopic third ventriculostomy (6.2%). Good functional recovery was achieved by
94.6% patients whereas residual disabilities accounted for 0.6% and mortality accounted
for 4.8%.
Conclusion: Outcome depended on initial AVPU score, admission into our Intensive Care
Unit and type of management. Surgical management resulted in better outcome but
vigilant monitoring for shunt complications is warranted. We recommend follow-up studies
using population-based longitudinal data and quantitative quality-of-life measures to
identify the specific long-term outcomes including the individual and social impacts of
childhood hydrocephalus in Africa.
Keywords
Functional outcome; Hydrocephalus; Pediatric neurosurgery
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