Overview of pediatric hydrocephalus in Nigeria: A systematic review

Hydrocephalus, a prevalent pediatric neurological condition, results from abnormal cerebrospinal fluid accumulation within the brain's ventricular system. Its causes are broadly classified as congenital or acquired. Early surgical intervention is pivotal for achieving favorable neurological outcomes. This systematic review synthesized data on hydrocephalus in Nigeria from 1962 to 2023, analyzing 87 studies involving 3,380 patients. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, drawing from seven databases, including PubMed, Embase, and African Journals Online. The extracted data encompassed patient demographics, clinical presentations, diagnostic tools, interventions, and outcomes. The mean patient age was 25.52 months (± 17.58), with a male-to-female ratio of 1.3:1. Macrocephaly was the most common clinical presentation, and most patients sought care within the first three months of life. Congenital causes, particularly aqueductal stenosis, accounted for 44% of cases. Ultrasonography, air ventriculography, and computed tomography (CT) were the primary diagnostic tools. Ventriculoperitoneal shunting (VPS) was the most frequently employed intervention, although shunt-related complications were common. Across all studies, 49 mortalities were reported. Timely intervention, especially ventriculoperitoneal shunting (VPS), is key to effectively managing hydrocephalus and improving neurological outcomes, as shown by its frequent use in the reviewed studies. Early diagnosis, primarily through computed tomography (CT), is crucial, with most patients presenting within the first three months of life. These findings emphasize the importance of prompt surgical treatment to reduce complications and mortality, highlighting the need for improved access to diagnostics and care.