Clinical Characteristics, Causes, and Treatment Outcomes of Hydrocephalus in Children Under Six: A Retrospective Study from a Single Center in Quetta, Baluchistan

Background. Hydrocephalus is defined by an abnormal build-up of Cerebrospinal Fluid (CSF) within the brain's ventricles. The long-term effects of hydrocephalus can range considerably and are frequently unpredictable. Due to its life-threatening nature, particularly in newborns and toddlers, the treatment of hydrocephalus is of utmost importance. The exact epidemiology of infantile hydrocephalus in Pakistan is unknown. \ Methods. This retrospective cohort study intended to examine the clinical importance of hydrocephalus patients under 6 years. Furthermore, it also addressed the potential gaps in medical knowledge on the local epidemiology, risk factors, and therapeutic methods of this condition at a tertiary care centre of Quetta Baluchistan, Pakistan. Results. A total of 29 hydrocephalus patients (18 congenital and 11acquired) were included in the study. A comprehensive questionnaire was designed to collect the demographic and clinical information of the patients. After statistical analysis, it was determined that gender and age distribution between the two groups, congenital and acquired hydrocephalus, was similar, showing no significant differences (p=0.196, p=0.867). The most common symptoms were irritability, drowsiness, and a head growing through seizures. Moreover, sun-setting eyes also appeared commonly. Post-natal diagnosis and imaging (CT and MRI) dominated the diagnostic methods of congenital hydrocephalus. Whereas brain MRI accounted for most cases with acquired hydrocephalus. The origin of acquired hydrocephalus was frequently unknown, aqueduct stenosis was the primary cause of congenital hydrocephalus. Medical treatment, ventriculoperitoneal (VP) shunting, and ETV (Endoscopic Third Ventriculostomy) were similar in all groups. The most frequent side effect for medications and VP shunts was irritation, while the most frequent side effect for ETV operations was sore throat. Conclusion. This study underlined the importance of early diagnosis, proper treatment, and continuous follow-up in hydrocephalus patients. Though the treatment approaches in accordance with clinical practices, the frequency of complications has necessitated continued medical care to achieve the best possible outcomes. Further research into the local epidemiology and more effective therapeutic approaches is very important to enhance care for hydrocephalus patients in the region.