Child's Nerv Syst (1994) 10:384-387 9 Springer-Verlag 1994 Jorma Kokkonen Willy Serlo Anna-Liisa Saukkonen Antero Juolasmaa Long-term prognosis for children with shunted hydrocephalus Received: 26 July 1993 J. Kokkonen ([]) - W. Serlo A.-L. Saukkonen Department of Pediatrics, University Central Hospital of Oulu, SF-90220 Oulu, Finland Fax: 358-81-315 55 59 A. Juolasmaa Department of Neurosurgery, University Central Hospital of Oulu, SF-90220 Oulu, Finland Abstract We reviewed the previous medical history and the social sta- tus of all patients of Oulu Universi- ty Central Hospital who had had in the age range 16-26 years shunted hydrocephalus (HC) during child- hood. Of 42 patients selected 7 had died and another 5 had been insti- tutionalized for severe mental hand- icap. Shunts had been changed a total of 103 times in 29 patients still living. The most common reason for a reoperation was blockage. Half of the patients re-examined showed neurological abnormalities or epilepsy. Both the verbal and the nonverbal IQ of the patients re- mained weak to average. Even though the patients' medical prog- nosis was fair, their social matura- tion did not keep up with their physical abilities. One-third were receiving or had received vocational training, but only a few were work- ing. Up to one-quarter of the pa- tients with shunted HC were at home without any meaningful work activities. Key words Hydrocephalus Social outcome 9 Young adults Introduction Reports concerning the long-term outcome of young per- sons who underwent shunting for hydrocephalus (HC) during their childhood are few [2, 3]. Successful treatment was developed only in the 1970s and the treatment of various complications (blockage, overdrainage, infec- tions) has been gradually refined. We report here the medical and social outcome of pa- tients treated at Oulu University Central Hospital. Patients and methods We enrolled in this series all adolescents and young adults over 15 years of age who had had shunted HC in childhood and who were from an area with a population of about 250,000 serviced by Oulu University Central Hospital, born between the years 1963 and 1975, and living at home, irrespective of their mental state. As our unit functions as a primary hospital for children with neurological problems, we consider the group as having been epidemiologically selected. Out of 52 selected subjects 7 had died. Of the rest 5 had been institutionalized for mental handicap and were not invited for re-ex- amination. Twenty-eight (10 males and 18 females, average age 19.5 years, range 15-26 years) came personally to the outpatient clinics for re-examination, and another two responded to a questionnaire. The patients had been followed up in the outpatient clinics of the Department of Paediatrics until they were between 16 and 18 years of age and had thereafter been referred to local health centers or adult units for follow-up. A stenosis of the aqueduct or some other anomaly at the base of skull or brain was the most common reason for HC, accounting for 15 (36%) of the patients. The others in order were spina bifida (19%), brain tumor (12%), infection (12%), neonatal hemorrhage (14%), and a cyst or other defect in the brain (7%). In half (55%) of the patients, HC was diagnosed at under 3 months of age and in 71% before 2 years of age. The first shunt was usually assessed just after diagnosis. The social outcome of the patients was compared to a random sample of 211 controls (105 men and 106 women, aged 22.9 years on average, range 19-25 years) born and living in the same area. The study design included a clinical examination by a pediatric neurologist and a surgeon with computed tomography (CT) scans