Disabilities in children with hydrocephalus--a population-based study of children aged between four and twelve years.
BACKGROUND
Children with hydrocephalus represent a heterogeneous group with various aetiologies and disability profiles. Over the years, continuous changes in medical care have occurred and updated information is important.


OBJECTIVE
To study disability profiles in aetiological and gestational age subgroups of children with hydrocephalus in the 1990s.


METHODS
A population-based series of 114 children, 70 with infantile hydrocephalus and 44 with hydrocephalus associated with MMC. All the children were examined clinically and interviewed.


RESULTS
Learning disabilities were present in 47 % of children with infantile hydrocephalus compared with 16 % of those with MMC, cerebral palsy in 27 % vs. zero and epilepsy in 34 vs. 11 %. Even after excluding children with cerebral palsy, the majority had abnormal tendon reflexes and scored below the 5th centile on a motor test. Hydrocephalus overt at birth, low gestational age, a perinatal origin, enlarged ventricles at follow-up and several shunt revisions all indicated risk factors for a poor outcome.


CONCLUSIONS
In spite of major advances in management, hydrocephalus in children still has a considerable impact on outcome. Being born very preterm and with a hydrocephalus that is already overt at birth involve the highest risk of a poor outcome. Apart from major impairments, the children frequently have definite motor problems.
Persson
E-K
EK
Department of Paediatrics, County Hospital, Halmstad, Sweden.
Hagberg
G
G
Uvebrant
P
P
D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology*; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology; D019102:Infant, Very Low Birth Weight; D007859:Learning Disabilities / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008591:Meningomyelocele / Q000175:diagnosis / Q000453:epidemiology; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011159:Population Surveillance; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000453:epidemiology; D012021:Reflex, Abnormal / Q000502:physiology; D012307:Risk Factors; D013548:Sweden