Long-term outcomes in patients with treated childhood hydrocephalus.

Gupta N, Park J, Solomon C, Kranz DA, Wrensch M, Wu YW. Long-term outcomes in patients with treated childhood hydrocephalus. Journal of Neurosurgery. 2007 May;106(5 Suppl):334-9.

OBJECT: The goal in this study was to determine the long-term effects of childhood hydrocephalus.

METHODS: A patient-reported survey completed by 1953 participants was used to collect data in a subgroup of 1459 individuals who had been treated for hydrocephalus in childhood. Data on shunt complications, including total shunt revisions and infections, were examined in those whose hydrocephalus had been diagnosed at least 10 years earlier (718 patients). Social and functional outcomes were examined in patients who were 20 years of age or older at the time of survey completion (403 individuals). Specific questions addressed the presence of depression, the patient's marital status, independent living arrangements, and the educational level attained. Shunt complications were common; 54% of patients had four or more shunt revisions, and 9% had three or more shunt infections. Depression requiring treatment occurred in 45% of participants. Other measures of social functioning all reflected a major impact of childhood hydrocephalus. In general, a worse outcome was found in patients whose hydrocephalus was diagnosed before 18 months of age.

CONCLUSIONS: The lifelong morbidity associated with shunt placement to treat childhood hydrocephalus is substantial, and it includes shunt-related complications and comorbidities that adversely affect social functioning.

PMID: 17566197

Prospective, declarative, and nondeclarative memory in young adults with spina bifida.

Dennis M, Jewell D, Drake J, Misakyan T, Spiegler B, Hetherington R, Gentili F, Barnes M. Prospective, declarative, and nondeclarative memory in young adults with spina bifida. Journal of the International Neuropsychological Society. 2007 Mar;13(2):312-23.


The consequences of congenital brain disorders for adult cognitive function are poorly understood. We studied different forms of memory in 29 young adults with spina bifida meningomyelocele (SBM), a common and severely disabling neural tube defect. Nondeclarative and semantic memory functions were intact. Working memory was intact with low maintenance and manipulation requirements, but impaired on tasks demanding high information maintenance or manipulation load. Prospective memory for intentions to be executed in the future was impaired. Immediate and delayed episodic memory were poor. Memory deficits were exacerbated by an increased number of lifetime shunt revisions, a marker for unstable hydrocephalus. Memory status was positively correlated with functional independence, an important component of quality of life.

PMID: 17286888