Introduction: Developing countries face the greatest burden of pediatric hydrocephalus, there are inadequate data to determine the prevalence and incidence of hydrocephalus. This liability is related to more health challenges, etiology assumed to correspond to high birth rates, maternal and perinatal risk factors, malnutrition education gaps, also greater risk of untreated neonatal or even prenatal infections and neural tube defects [1]. Hydrocephalus (Primary and secondary) remain one of the commonest and devastating pediatric neurosurgical pathologies. Incidence of congenital hydrocephalus has been estimated to be 0.2- 0.8/1000 live births [2]. Unique challenges affecting the treatment of hydrocephalus in the developing world include …show more content…
There were no technical difficulties in the procedure even in the cases associated with anatomical distortion of the floor of the third ventricle due to the associated congenital anomalies. Based on the preoperative radiological imaging, 42 patients (63.7%) diagnosed to have non-communicating (obstructive) hydrocephalus and 29 patients (32.7%) had communicating hydrocephalus, however in 44 cases HCP associated with MMC. The signs and symptoms of increased intracranial pressure resolved after ETV in all patients. Follow-up brain CT scan showed no complications related to the third ventriculostomy except for insignificant asymptomatic Pneumocephalus in 11 cases. The initial clinical success rate was 82% and decreased slightly to 78% during long-term follow-up. The size of ventricles showed a reduction in 51 cases (93%) (Figure 1). Four patients developed fever and meningeal irritation signs and symptoms after 3 days from ETV, the external ventricular drain was inserted and antibiotics started for one week. The patient improved, drain removed, patients maintained on antibiotics for another week with no