Hydrocephalus in infancy and childhood. Our experience of CSF shunting.

A surgical series of 346 children with nontumoral hydrocephalus shunted in the period January 1957 to December 1973 is presented. The etiological factors, preoperative clinical and anatomical status of the patients, their surgical career, the reasons for revision operations and causes of death, are analyzed and discussed in relation to each of the four groups constituting the series: tetraventricular communicating hydrocephalus, triventricular hydrocephalus, obstructive hydrocephalus from ventriculocisternal block and postmeningocele or postmyelomeningocele hydrocephalus. 141 patients required 218 revision operations. 16 patients died after the first operation, 27 on revision and 38 sometime later. 41 patients were lost to follow-up. A recent clinical and instrumental review of the physical, neurological and mental status of the remaining 224 patients showed that 136 (60.7%) are well or very well, 68 (30.3%) have residual deficits likely to regress with treatment and 20 (8.9%) are severely handicapped. These long-term results and the surgical aspects of the problem are discussed in the light of the literature.