Surgical management and outcomes of childhood hydrocephalus in a resource-challenged setting in Northeast Nigeria

Background: Hydrocephalus is the most common neurosurgical presentation among pediatric patients in our center. The specificity of children with this condition justifies special care by a team comprising of pediatric neurosurgeons, anesthesiologist and nurses. A ventriculoperitoneal shunt is the surgical treatment we offer these patients, as facilities for other treatment options are unavailable. This study aimed to determine the outcomes of surgical management of childhood hydrocephalus in our center. Patients and methods: A retrospective observational study that recruited all pediatric patients aged 16 years and below who had surgical intervention for hydrocephalus in our facility from January 2019 to December 2021. Data was analyzed using simple descriptive statistics. Results: A total of 73 pediatric patients with hydrocephalus were recruited. The majority (53.4%) were males with a male-to-female ratio of 1.1:1. Most of the patients (53.4%) had acquired hydrocephalus and had ventriculoperitoneal shunt (93.2%) as surgical intervention. Nineteen point two percent (14 patients) had postoperative complications. Proximal shunt obstruction (6.9%); followed by surgical site infection (5.5%) were the most common and occurred commonly in those operated during infancy period. Mortality was higher in patients that had external ventricular drain (EVD). Overall mortality was 5.5%. Conclusion: Acquired hydrocephalus is the most common type of hydrocephalus in children in our center. Ventriculoperitoneal shunt remains the surgical treatment employed with favorable outcomes despite limitations.