Affiliation:
1. Department of Pediatric Neurosurgery, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran;
2. Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; and
3. Department of Pediatric Neurosurgery, Akbar Children’s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
OBJECTIVE
The goal of this study was to investigate and identify the predictors associated with the incidence of hydrocephalus requiring shunt insertion in patients with encephalocele (EC), and to develop a scoring system to estimate the probability of hydrocephalus occurrence over time in these patients.
METHODS
A retrospective analysis was undertaken on data from patients treated for EC at a tertiary medical center between 2010 and 2021. Data including patient age at presentation, sex, sac location, sac size, contents, presence of ventriculomegaly/hydrocephalus, CSF leakage, and other associated intracranial/extracranial anomalies were among the variables evaluated for their predictive value. In addition, logistic regression analyses were performed to identify the independent predictors. A predictive scoring system was developed based on regression coefficients.
RESULTS
A total of 102 cases of EC were identified. The patient group consisted of 52 boys and 50 girls. Seventy-one patients (69.6%) had posterior ECs. Forty-three (42.2%) of the ECs contained neural tissue. Thirty-three patients presented with ventriculomegaly (32.4%), 30 of whom (90.9%) underwent ventriculoperitoneal shunt placement for hydrocephalus. Multivariate analysis revealed that the presence of other associated anomalies (OR 2.8, 95% CI 1.1–7.4, p = 0.027), larger EC sac size (OR 1.3, 95% CI 1.01–1.6, p = 0.042), and infections (OR 6.8, 95% CI 1.3–34.8, p = 0.034) were associated with ventriculomegaly. The logistic regression model consisted of 5 variables including the patients’ history of meningitis, their sex, sac location, sac size, and presence of other other associated anomalies; analysis resulted in the maximum accuracy of 86% for the prediction of hydrocephalus occurrence.
CONCLUSIONS
According to the findings, the presence of other associated anomalies, a larger sac, and infections are significant independent predictors of hydrocephalus. By considering these 3 predictors as well as sac location and the patient’s sex, it will be possible to predict hydrocephalus occurrence in patients with EC with significant accuracy.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Reference32 articles.
1. Perioperative management of children with encephalocele: an institutional experience;Mahajan C,2011
2. Anterior encephaloceles in children of Assamese tea workers;Dutta HK,2010
3. Encephalocele in Uganda: ethnic distinctions in lesion location, endoscopic management of hydrocephalus, and survival in 110 consecutive children;Warf BC,2011
4. Hydrocephalus and occipital encephaloceles: presentation of a series and review of the literature;Protzenko T,2021
5. Risk factors for hydrocephalus and neurological deficit in children born with an encephalocele;Da Silva SL,2015
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献