[P3-25] Role of ventriculoperitoneal shunt surgery in neonates and infants with hydrocephalus induced by bacterial meningitis
[Introduction] Hydrocephalus induced by acute bacterial meningitis (BMH) remains a relatively uncommon but potentially fatal condition in childhood. Studies on ventriculoperitoneal shunt (VPS) in BMH are few, especially for neonates and infants. The aim is to evaluate the role of VPS in BMH.
[Methodology] Cases of BMH were collected from 2010 to 2016 in a single large teaching medical center in China. All patients were given VPS with clinical follow-up until April 2016.
[Results] 15 BMH patients, including 7 preterm babies who had undergone VPS, were included. The average age was 2.4 months (ranging from 1 day to 11 months). All were diagnosed with obstructive hydrocephalus except for 2 with communicating hydrocephalus. The majority of the bacterial meningitis cases were complicated with hydrocephalus at admission. The average interval from the initial symptoms to VPS was 4.2 months (ranging from 1 to 11 months). 8 suffered postsurgical complications involving infection, catheter obstruction, seizures, and cerebrospinal fluid (CSF) leak. By the end of the follow-up period, 3 had died, resulting in a case-fatality rate (CFR) of 20%. 7 had a complete recovery, 3 have neurological sequelae, and the other 2 dropped out of the study during the follow-up period.
[Conclusions] VPS is an effective method to relieve pressure caused by hydrocephalus in neonates and infants. However, complications after surgery could lead to poor outcomes. Completely normal features of CSF should not be considered the most important indication in the timing of VPS which does not reduce the risk of post-surgical complications.
[Methodology] Cases of BMH were collected from 2010 to 2016 in a single large teaching medical center in China. All patients were given VPS with clinical follow-up until April 2016.
[Results] 15 BMH patients, including 7 preterm babies who had undergone VPS, were included. The average age was 2.4 months (ranging from 1 day to 11 months). All were diagnosed with obstructive hydrocephalus except for 2 with communicating hydrocephalus. The majority of the bacterial meningitis cases were complicated with hydrocephalus at admission. The average interval from the initial symptoms to VPS was 4.2 months (ranging from 1 to 11 months). 8 suffered postsurgical complications involving infection, catheter obstruction, seizures, and cerebrospinal fluid (CSF) leak. By the end of the follow-up period, 3 had died, resulting in a case-fatality rate (CFR) of 20%. 7 had a complete recovery, 3 have neurological sequelae, and the other 2 dropped out of the study during the follow-up period.
[Conclusions] VPS is an effective method to relieve pressure caused by hydrocephalus in neonates and infants. However, complications after surgery could lead to poor outcomes. Completely normal features of CSF should not be considered the most important indication in the timing of VPS which does not reduce the risk of post-surgical complications.