title: On the changing epidemiology of hydrocephalus.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the changing epidemiology of paediatric hydrocephalus over the past three decades in a single institution.
  
  
  METHODS
  All children treated for newly diagnosed hydrocephalus during the 1985-1990 (group A) and the 2000-2005 periods (group B) were enrolled and classified according to the associated cause of hydrocephalus.
  
  
  RESULTS
  A significant 8.8% decrease of the incidence of hydrocephalus was noticed between the two time periods, resulting from the reduction of hydrocephalus associated to myelomeningocele, aqueduct stenosis (p = 0.04), CNS infection (p = 0.03), cranio-cerebral malformation and head injuries; post-haemorrhagic hydrocephalus remained stable, while the tumour-associated one increased (p < 0.0001). No consistent differences in terms of rate of adjunctive surgery (30.3% versus 23.9%) and number revision procedures (200 versus 104) were recorded.
  
  
  CONCLUSIONS
  The present study confirmed data from the literature about the declined incidence of paediatric hydrocephalus, which mainly results from the decrease of congenital malformations. In spite of the recent advances in neuroendoscopy and in the shunting valve design, the impact of hydrocephalus in the paediatric neurosurgical practice remains high.
authors.affiliation: Paediatric Neurosurgery-Institute of Neurosurgery, Policlinico A. Gemelli, Largo A. Gemelli, 8, 00168, Rome, Italy. lmassimi@email.it
authors.forename: Luca
authors.initials: L
authors.lastname: Massimi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Paternoster
authors.forename: Teresa
authors.initials: T
authors.lastname: Fasano
authors.forename: Concezio
authors.initials: C
authors.lastname: Di Rocco
mesh_terms: D000367:Age Factors; D001921:Brain / Q000002:abnormalities; D002494:Central Nervous System Infections / Q000150:complications / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications / Q000453:epidemiology; D019465:Craniofacial Abnormalities / Q000150:complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications / Q000453:epidemiology; D006470:Hemorrhage / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D015994:Incidence; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000453:epidemiology