REVIEW ARTICLES

Hydrocephalus management challenges in a low-income country: A review article

Christopher O Anele, Henry E Omon, Simon A Balogun, Temitope O Ajekwu, Edward O Komolafe

Neurosurgery Unit, Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun State, Nigeria

Correspondence Address:
Dr. Christopher O Anele
Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun State Nigeria

Source of Support: None
Conflict of Interest: None

Hydrocephalus is a very common brain disorder affecting both children and adult populations. Its global burden has been well documented in the literature, and its management is not without challenges and complications, especially in low-income countries. This study aims at reviewing the management of hydrocephalus in a tertiary hospital in Nigeria and illustrating two cases managed with peculiar challenges. This study is a retrospective clinical review of 170 patients with hydrocephalus amenable to ventriculoperitoneal shunting as primary treatment. Two cases of hydrocephalus with peculiar management challenges were illustrated. The first case was that of an abandoned infant with hydrocephalus. The second case was that of a 5-year-old boy with post-meningitic hydrocephalus with delays in having cerebrospinal fluid (CSF) shunting. Majority of the patients with hydrocephalus were infants (71.2%), and the top two most common etiologies were aqueductal stenosis (64.7%) and post-meningitic hydrocephalus (11.2%), respectively. Shunt infection was the most common complication (9.4%), which was within the lower limit of rates reported in the literature (8.6%–50%). Approximately 84% of shunting had no complication. In conclusion, ventriculoperitoneal shunting is the preferred treatment option for hydrocephalus in low-income countries, and it is not without management challenges that are peculiar to these climes. Shunt infection appeared to be the most common complication.