Hydrocephalus at the University Hospital of the West Indies

ABSTRACT

OBJECTIVES: To define the aetiology of hydrocephalus and to investigate the presumed high frequency of post meningitic hydrocephalus at the University Hospital of the West Indies (UHWI). To study whether the pattern of hydrocephalus seen at UHWI may be amenable to alternative treatment (neuroendoscopy). METHODS: A retrospective review was carried out between August 2000 and July 2001. The department of Surgery's operative audit and admissions database along with the personal database of one of the authors (IC) were accessed. From this, we were able to retrieve 100 patient logs from the records department of UHWI. RESULTS: The male to female ratio was 11 and the age range was from one day to 70 years (mean 15 years). The leading causes of hydrocephalus were aqueduct stenosis (20), and tumour associate hydrocephalus (17). These were followed by post haemorrhagic (14), post meningitic (9) and communicating hydrocephalus not otherwise specified. The more common presenting complaints were enlarging head (32), headache (22), vomiting (21), seizures (11), papilloedema (9), ataxia (9) and neck stiffness (3). CONCLUSION: Aqueductal stenosis was the most common aetiological factor giving rise to hydrocephalus whereas post meningitic hydrocephalus was not very common. Neuroendoscopy is now well accepted in the management obstructive hydrocephalus. Given the frequency of aqueductal stenosis, neuroendoscopy maybe a feasible alternative in the treatment of hydrocephalus at UHWI. (AU)