Malovichko I. Hydrocephalus of critical degree in children (etiology, diagnostics and treatment)

Thesis is devoted to the actual topic ? improvement of results of surgical treatment of hydrocephalus of critical (HCD) degree in children. The comparative analysis of features of flow, diagnostics and surgical treatment of congenital, post-inflammatory, posthemorrhagic and combined HCD was provided. The most favorable flow and better long-term outcomes were observed at congenital hydrocephalus, not associated with CNS malformations, at which in 60% cases after surgery good and satisfactory quality of life was achieved. Most often poor quality of life (over 51%) was observed in patients with peri-intraventricular hemorrhages of III and IV degree, hypoxic-ischemic brain lesions combined with infectious and inflammatory CNS diseases in the first months of life. In 63.3% children, been operated in the first 6 months of life, good quality of life was achieved, while in cases of late treatment satisfactory quality of life was defined only in 41.3% patients. More often poor quality of life was detected in patients with infectious and inflammatory complications, especially in the early postoperative period (in 57% cases), less often - at hyperdrainage (in 49.2%) and shunt system's dysfunction (in 31.1%). The decrease of number of children with poor quality of life from 64.3 to 37% after operation and increase of number of patients with satisfactory development from 22 to 36.4% justifies the need for surgical intervention in patients with HCD. Application of developed diagnostic and treatment scheme, using rational surgical tactics will improve diagnosis, reduce postoperative complications incidence and improve quality of life of children with HCD.