Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results

Matthias Gmeiner, Helga Wagner, Claudia Schlögl, Willem J. R. van Ouwerkerk, Wolfgang Senker, Gracija Sardi, Philip Rauch, Kurt Holl, Andreas Gruber

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: Very long-term outcomes are rarely reported for patients with shunted pediatric hydrocephalus. This study aimed to determine the functional, social, and neurocognitive outcomes of such patients after transition to adulthood. Methods: Adult patients with pediatric hydrocephalus who underwent their first shunt operation between 1982 and 1992 were included. Functional, social, educational, working aspects, and verbal intelligence were evaluated. In patients with average or above average verbal intelligence, detailed neuropsychological testing was performed and memory, executive functioning, selective attention, and concentration were assessed. Results: Overall, 137 patients underwent primary surgery because of pediatric hydrocephalus, 53 (38.7%) of whom died during the follow-up period. Of the 84 long-term survivors, 65 (77.4%) agreed to participate and were included for further analysis. Forty-five patients (69.2%) had completed secondary school, but only 34 (52.3%) were integrated in the open labor market. Although the verbal intelligence of 31 patients (47.7%) was within the normal range, 19 (29.2%) had a severe mental handicap. Shunt infections (P = 0.0025), epilepsy (P < 0.0001), and the number of shunt operations (P = 0.0082) were associated with reduced verbal intelligence. Most patients with average or above average verbal intelligence had deficits in detailed neuropsychological testing. In 23 patients, detailed neuropsychological testing was performed. Conclusions: The overall long-term outcome of patients with shunted pediatric hydrocephalus is poor. These results highlight the importance of lifelong routine controls to avoid later complications. Further, repeated neuropsychological examinations might be important to understand the patient's special needs to optimize professional support.
Original languageEnglish
JournalWorld Neurosurgery
DOIs
Publication statusPublished - 2019

Cite this

Gmeiner, Matthias ; Wagner, Helga ; Schlögl, Claudia ; van Ouwerkerk, Willem J. R. ; Senker, Wolfgang ; Sardi, Gracija ; Rauch, Philip ; Holl, Kurt ; Gruber, Andreas. / Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results. In: World Neurosurgery. 2019.
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title = "Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results",
abstract = "Objective: Very long-term outcomes are rarely reported for patients with shunted pediatric hydrocephalus. This study aimed to determine the functional, social, and neurocognitive outcomes of such patients after transition to adulthood. Methods: Adult patients with pediatric hydrocephalus who underwent their first shunt operation between 1982 and 1992 were included. Functional, social, educational, working aspects, and verbal intelligence were evaluated. In patients with average or above average verbal intelligence, detailed neuropsychological testing was performed and memory, executive functioning, selective attention, and concentration were assessed. Results: Overall, 137 patients underwent primary surgery because of pediatric hydrocephalus, 53 (38.7{\%}) of whom died during the follow-up period. Of the 84 long-term survivors, 65 (77.4{\%}) agreed to participate and were included for further analysis. Forty-five patients (69.2{\%}) had completed secondary school, but only 34 (52.3{\%}) were integrated in the open labor market. Although the verbal intelligence of 31 patients (47.7{\%}) was within the normal range, 19 (29.2{\%}) had a severe mental handicap. Shunt infections (P = 0.0025), epilepsy (P < 0.0001), and the number of shunt operations (P = 0.0082) were associated with reduced verbal intelligence. Most patients with average or above average verbal intelligence had deficits in detailed neuropsychological testing. In 23 patients, detailed neuropsychological testing was performed. Conclusions: The overall long-term outcome of patients with shunted pediatric hydrocephalus is poor. These results highlight the importance of lifelong routine controls to avoid later complications. Further, repeated neuropsychological examinations might be important to understand the patient's special needs to optimize professional support.",
author = "Matthias Gmeiner and Helga Wagner and Claudia Schl{\"o}gl and {van Ouwerkerk}, {Willem J. R.} and Wolfgang Senker and Gracija Sardi and Philip Rauch and Kurt Holl and Andreas Gruber",
year = "2019",
doi = "10.1016/j.wneu.2019.08.167",
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Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results. / Gmeiner, Matthias; Wagner, Helga; Schlögl, Claudia; van Ouwerkerk, Willem J. R.; Senker, Wolfgang; Sardi, Gracija; Rauch, Philip; Holl, Kurt; Gruber, Andreas.

In: World Neurosurgery, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results

AU - Gmeiner, Matthias

AU - Wagner, Helga

AU - Schlögl, Claudia

AU - van Ouwerkerk, Willem J. R.

AU - Senker, Wolfgang

AU - Sardi, Gracija

AU - Rauch, Philip

AU - Holl, Kurt

AU - Gruber, Andreas

PY - 2019

Y1 - 2019

N2 - Objective: Very long-term outcomes are rarely reported for patients with shunted pediatric hydrocephalus. This study aimed to determine the functional, social, and neurocognitive outcomes of such patients after transition to adulthood. Methods: Adult patients with pediatric hydrocephalus who underwent their first shunt operation between 1982 and 1992 were included. Functional, social, educational, working aspects, and verbal intelligence were evaluated. In patients with average or above average verbal intelligence, detailed neuropsychological testing was performed and memory, executive functioning, selective attention, and concentration were assessed. Results: Overall, 137 patients underwent primary surgery because of pediatric hydrocephalus, 53 (38.7%) of whom died during the follow-up period. Of the 84 long-term survivors, 65 (77.4%) agreed to participate and were included for further analysis. Forty-five patients (69.2%) had completed secondary school, but only 34 (52.3%) were integrated in the open labor market. Although the verbal intelligence of 31 patients (47.7%) was within the normal range, 19 (29.2%) had a severe mental handicap. Shunt infections (P = 0.0025), epilepsy (P < 0.0001), and the number of shunt operations (P = 0.0082) were associated with reduced verbal intelligence. Most patients with average or above average verbal intelligence had deficits in detailed neuropsychological testing. In 23 patients, detailed neuropsychological testing was performed. Conclusions: The overall long-term outcome of patients with shunted pediatric hydrocephalus is poor. These results highlight the importance of lifelong routine controls to avoid later complications. Further, repeated neuropsychological examinations might be important to understand the patient's special needs to optimize professional support.

AB - Objective: Very long-term outcomes are rarely reported for patients with shunted pediatric hydrocephalus. This study aimed to determine the functional, social, and neurocognitive outcomes of such patients after transition to adulthood. Methods: Adult patients with pediatric hydrocephalus who underwent their first shunt operation between 1982 and 1992 were included. Functional, social, educational, working aspects, and verbal intelligence were evaluated. In patients with average or above average verbal intelligence, detailed neuropsychological testing was performed and memory, executive functioning, selective attention, and concentration were assessed. Results: Overall, 137 patients underwent primary surgery because of pediatric hydrocephalus, 53 (38.7%) of whom died during the follow-up period. Of the 84 long-term survivors, 65 (77.4%) agreed to participate and were included for further analysis. Forty-five patients (69.2%) had completed secondary school, but only 34 (52.3%) were integrated in the open labor market. Although the verbal intelligence of 31 patients (47.7%) was within the normal range, 19 (29.2%) had a severe mental handicap. Shunt infections (P = 0.0025), epilepsy (P < 0.0001), and the number of shunt operations (P = 0.0082) were associated with reduced verbal intelligence. Most patients with average or above average verbal intelligence had deficits in detailed neuropsychological testing. In 23 patients, detailed neuropsychological testing was performed. Conclusions: The overall long-term outcome of patients with shunted pediatric hydrocephalus is poor. These results highlight the importance of lifelong routine controls to avoid later complications. Further, repeated neuropsychological examinations might be important to understand the patient's special needs to optimize professional support.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/31479789

U2 - 10.1016/j.wneu.2019.08.167

DO - 10.1016/j.wneu.2019.08.167

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JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

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