Outcome of Management of Abnormal CSF Circulation in Children

Authors

Kemel Ahmed Ghotme, M.D.

James M. Drake, M.D.

Section Editor

Shlomi Constantini, M.D.

Editor in Chief

Rick Abbott, M.D.

Outcome After Medical Treatments

• Not available: There are no series reporting outcome for patients managed medically for benign extraaxial CSF collections. Its use is not indicated for other forms of CSF accumulations.

Outcome After Shunting

• Head size: When operated in a timely fashion, head circumference in shunted infants may lie in normal percentiles.
• Physical and intellectual abilities: In the absence of specific genetic syndromes, other abnormalities or complications and, depending on the degree of established brain damage prior to treatment, intelligence (measured through IQ scores), physical development and coordination of children with shunts is not different from the general population. Some patients might complain of minor disabilities or learning difficulties.
• QOL: Several studies have assessed QOL in patients with hydrocephalus treated with shunts. Most patients defined their QOL as good or average. Minor symptoms such as occasional headaches are common and usually do not have an impact on QOL. Frequent complications and need of shunt revisions may be responsible for deterioration of QOL.

Outcome after Third Ventriculostomy

• 60–80% success rate: Most larger series have reported a 60–80% success rate in managing symptomatic hydrocephalus with an ETV (49-57).
• 80–100% success rate with midbrain obstruction: Most series have reported higher success rates for obstructive hydrocephalus due to a midbrain or aqueductal obstruction (49, 50, 56, 58).