Renier et al identified prognostic factors associated with outcome for a patient born with hydrocephalus. This can help counsel parents about the risk for an adverse outcome. The authors are from Hopital des Enfants Malades in Paris, France.


Patient selection: increased head circumference and enlarged ventricles at birth due to hydrocephalus



(1) prematurity

(2) spina bifida

(3) meningomyelocele

(4) early hydrocephalus (normal head circumference with bulging fontanelles and enlarged ventricles)


Adverse outcomes to hydrocephalus (and/or underlying malformations)

(1) premature death

(2) mental retardation

(3) psychological problems


Poor prognostic factors:

(1) associated malformation(s) present (including Dandy-Walker malformation)

(2) shunt infection after shunt surgery

(3) shunt malfunction

(4) communicating hydrocephalus

(5) aqueductal stenosis (noncommunicating hydrocephalus) due to toxoplasmosis

(6) aqueductal stenosis (noncommunicating hydrocephalus) due to X-linked hydrocephalus

(7) severe hydrocephalus at birth

(8) developmental quotient at 6 months <= 80


Favorable prognostic findings for final IQ:

(1) re-expansion of cerebral mantle after shunt operation

(2) developmental quotient at 6 months > 80


The authors note that infants with hydrocephalus and spina.bifida or meningomyelocele tend to have a better prognosis for final IQ than infants with hydrocephalus from other causes.


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