Hydrocéphalie du nouveau-né et du nourrisson au Centre Hospitalier National de Nouakchott

Neonatal and infant hydrocephalus is an important factor for mortality and morbidity in developing countries with limited diagnostic and therapeutic means. The purpose of this study was to report our experience in the management of this disease in Mauritania. We conducted a retrospective study of 126 medical records of newborns aged 0-24 months treated for hydrocephalus in the Department of Neurosurgery at the Nouakchott National Hospital from June 2014 to June 2018. Mean follow-up time was 15 months (9-27 months). The average age of patients was 5 months (2 days-20 months). Highest prevalence was observed among female babies (sex ratio 0.77). Our case series consisted of 45 newborns (35.7%) and 81 infants (64.3%). A history of infection during pregnancy was found in 19.8% of cases and neonatal infection in 23.8% of cases. Clinically, 87.3% had macrocephalus, 35.7% had psychomotor retardation and 15.8% refused to suckle. The main cause was myelomeningocele (23.8%), followed by meningitis (15.8%). Ventriculo-peritoneal derivation (VPD) was the first-line treatment in newborns (68.8%), while endoscopic ventriculocisternostomy (EDV) was the preferred approach in infants (74.1%). Overall complication rate was 26.1% (57.6% for VPD and 4.1% for EDV). Hydrocephalus is the most common disease treated by paediatric neurosurgeons in Africa. Management is usually delayed, hence the importance of prevention, especially of neural tube defects and infections.