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|Title:||Hydrocephalus in infancy|
|Citation:||Chan, K.Y. (1976). Hydrocephalus in infancy. Journal of the Singapore Paediatric Society 18 (2) : 62-75. ScholarBank@NUS Repository.|
|Abstract:||Hydrocephalus is defined as the increased accumulation of cerebrospinal fluid within the ventricles of the brain, with consequent ventricular dilatation and, in the case of babies and young children, associated progressive enlargement of the head from separation of the cranial sutures. The intracranial pressure is raised: high pressure hydrocephalus. The hydrocephalus is said to be communicating if there is communication between the ventricular system and the subarachnoid space and non-communicating if there is none. Tew and Laurence (1975) found that in a group of spina bifida cases, the mean IQ was lower in the 'arrested' hydrocephalus group, and lowest in the shunt-treated group, in which there was also a significant difference between the verbal and performance IQ. The mean full scale IQ of this shunt-treated group was only 70, with one-quarter above 80 and 3 had IQs above 100. This is in marked contrast with the other groups in which three-quarters were above 80 and one third had IQs above 100. The above authors also established the close correlation between low IQ, defective visual perception and poor school attainment (reading, spelling, and arithmetic). Extreme caution, however, must be exercised when comparing the results of operated and unoperated groups since they are not strictly comparable largely because of case selection, and differences in the severity of the hydrocephalic process, diagnostic criteria, and period of followup. This is particularly true when comparing the so-called 'natural arrest' group which by their very nature tended to be milder and the operated group which happens to have progressive hydrocephalus and which if untreated would have run a relentless course terminating fatally or with gross head enlargement and severe brain damage. The extracranial shunt operation while having dramatically changed the outlook of the child with progressive hydrocephalus for the better, is far from ideal, being plagued by late complications which remain a major problem.|
|Source Title:||Journal of the Singapore Paediatric Society|
|Appears in Collections:||Staff Publications|
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