TITLE:
Epidemiological and Clinical Aspects of Congenital Hydrocephalus in the Neonatal Department of Gabriel Touré Teaching Hospital Bamako Mali
AUTHORS:
Hawa G. Diall, Oumar Coulibaly, Youssouf Sogoba, Hatouma Sylla, Yacouba A. Coulibaly, Fatoumata L. Diakité, Lala N. Sidibé, Ibrahima Ahamadou, Leyla Maiga, Abdoul K. Doumbia, Pierre Togo, Adama Dembélé, Mohamed E. Cissé, Fousseini Traoré, Belco Maiga, Karamoko Sacko, Djeneba Konaté, Bourama Kané, Oumou Koné, Guedjouma Dembélé, Abdoul A. Diakité, Drissa Kanikomo, Fatoumata D. Traoré, Mariam Sylla, Boubacar Togo
KEYWORDS:
Newborn, Congenital Hydrocephalus, Mortality, Gabriel Toure
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.1,
January
7,
2022
ABSTRACT: Objective: The aim of our work was to access the epidemiological and clinical
aspects of congenital hydrocephalus in the pediatrics department of Gabriel
Touré teaching Hospital Bamako. Methods: We conducted a retro and
prospective study that ran from January, 1st 2018 to July, 30, 2019. All
newborns of 72 hours of life or less with hydrocephalus confirmed by sonography
or CT scan were enrolled in this study. Results: During the study
period, 5416 patients were hospitalized in the neonatology department. Among
them, 39 patients (0.72%) presented congenital hydrocephalus and congenital infectious causes
accounted for 25.6%. The sex ratio (M/F) was 1.78. Mothers were housewives and not
educated in 79.5% and 64.1% respectively. The parents resided outside Bamako in
61.5% of cases. Prenatal consultations were conducted in 32 patients (82%). Consanguinity between the 2 parents was present
in 38.5%. The antenatal diagnosis was made in 8 patients (20.5%). Vaginal
delivery was the main mode of birth (67%). The average birth weight was 2930 g (1000 to 5400 g) and the average head circumference was 37.82 cm
(26 - 55 cm). In 87.2% of cases, newborns were eutrophic. The main
clinical signs were bulging anterior fontanel (46.2%), sunset gaze (20.5%),
prominent forehead (48.7%), reduced face (20.5%), enlarged cranial sutures
(43.6%), macrocrania (25.6%). Transfontanellar ultrasound and CT scan were
performed in 51.3% and 48.7% of cases respectively. Associated malformations were spina bifida in
30.8% of cases followed by Dandy Walker malformation (5.1%), and omphalocele
(2.5%). The neurological signs were diminished neonatal reflexes (51.3%),
hypotonia (30.8%), motor deficit (38.4%), intracranial hypertension (25.6%),
seizures 10.25% and psychomotor delay (43.6%). Surgery was performed in 8 neonates (20.5%).
Ventriculo-peritoneal shunt (VPB) was the main treatment. Postoperative
complications were infectious (37.5%) and mechanical complications (12.5%). The
postoperative mortality rate was 12.5%.The overall mortality was 13 cases
(33.3%). Conclusion: The hospital frequency of congenital hydrocephalus in our environment
seems low but does not reflect reality.