Infantile Hydrocephalus: Health-Related Quality of Life Outcome following Ventriculoperitoneal Shunt

To investigate the impact of Ventriculo-Peritoneal Shunt (VPS) on the Health-Related Quality of Life (HRQOL) of children with the infantile hydrocephalus who underwent their first shunt insertion in the first year of life. To compare the outcome of health domains according to sex, follow-up period, etiology and shunt valve type (fixed versus programmable pressure).

102 children ≤1 years old at the time of new-onset hydrocephalus and shunt insertion. Age-appropriate PedsQL 4.0 versions were completed by the parents or caregivers with the assistance of single neurosurgery resident. Patients were divided into subgroups according to etiology; neural tube defect associated hydrocephalus (NTD-H), intra-ventricular hemorrhage associated with infantile hydrocephalus (IVH-H) and according to the shunt valve type; fixed versus programmable. Statistical analyses were performed using SPSS, IBM version 20. PedsQL 4.0 was presented using mean and standard deviations.

A decreasing social domain score at 1-3 years follow up (n=61) compared to 1 year follow up (n=41) was observed. The two groups did not differ significantly in sex distribution. The mean cognitive score was significantly lower in patients with IVH-H of prematurity compared to NTD-H. Better physical and cognitive domains in programmable shunts were compared to fixed pressure type.

IVH-H associated with worse cognitive function possibly due to associated brain damage was reported. With long-term follow-up, social function decline probably due to the patients’ awareness of their disability was observed. Programmable shunt valve is recommended over fixed type due to the improvement in physical and cognitive functions. Sex of the patients did not affect the outcome.