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