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<p>Pediatric hydrocephalus continues to pose a significant neurosurgical challenge in Nigeria driven by delayed diagnosis, barriers to treatment, and loss to long-term follow-up. Systemic, infrastructural, and socioeconomic limitations in hydrocephalus care persist across sub-Saharan Africa (SSA) despite major advances globally. This scoping review maps the current landscape of pediatric hydrocephalus in Nigeria, with emphasis on management trends, treatment outcomes, and context-specific challenges. We searched PubMed, Scopus, Web of Science, African Journals Online (AJOL), Nigerian Journal Online (NJOL), as well as grey literature, for studies published within the past 15 years. Eligible studies reported causes, management approaches, treatment outcomes, or barriers to care. Data were synthesized thematically in narrative form. Ten hospital-based studies (<i>n</i> = 1,127) conducted at tertiary institutions and spanning multiple geopolitical zones in Nigeria were included. All were cohort studies (eight retrospective and two prospective) and reported a male predominance. Congenital hydrocephalus, most commonly attributed to aqueductal stenosis and Chiari II malformations, was more common in infants and young children (40–90% across studies), while post-infectious causes were more common in older children. Ventriculoperitoneal (VP) shunting was the predominant treatment modality, while endoscopic third ventriculostomy (ETV) was used in a few centers. Shunt infections were the most common complication, with rates ranging from 11% to 28%. Late presentation was reported with presentation ages ranging between 1 and 12 months of age. High out-of-pocket expenses, limited access to advanced imaging, lack of trained neurosurgeons, and sociocultural barriers to timely care were among the challenges encountered. Pediatric hydrocephalus in Nigeria is characterized by delayed presentation, limited treatment options, and geographical disparities in care. Although ETV is gaining popularity as a treatment modality, VP shunting remains the standard of care. To improve outcomes, neurosurgical services should be decentralized, community-level awareness enhanced, insurance coverage expanded, and national guidelines for hydrocephalus management established. </p>

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Pediatric hydrocephalus in Nigeria: a scoping review of management, treatment outcomes, and challenges

  • 期刊论文

  • 发表日期：

    2026年5月20日

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  • Chidera Stanley Anthony,
  • Nwamaka Chidera Bob-Ume,
  • Ikponmwosa Jude Ogieuhi,
  • Victor Oluwatomiwa Ajekiigbe,
  • Victor Olamiposi Olaiya,
  • Oluchukwu Vivian Igwebuike,
  • Kingsley Chidi Anachuna,
  • Faith Temiloluwa Adetayo,
  • Chimaobi Nwevo,
  • Olufemi Akinmeji,
  • Temilade Patience Adejumo,
  • Kenechukwu Clinton Agudosi,
  • Azeezat Olajumoke Adekanmbi

摘要

Pediatric hydrocephalus continues to pose a significant neurosurgical challenge in Nigeria driven by delayed diagnosis, barriers to treatment, and loss to long-term follow-up. Systemic, infrastructural, and socioeconomic limitations in hydrocephalus care persist across sub-Saharan Africa (SSA) despite major advances globally. This scoping review maps the current landscape of pediatric hydrocephalus in Nigeria, with emphasis on management trends, treatment outcomes, and context-specific challenges. We searched PubMed, Scopus, Web of Science, African Journals Online (AJOL), Nigerian Journal Online (NJOL), as well as grey literature, for studies published within the past 15 years. Eligible studies reported causes, management approaches, treatment outcomes, or barriers to care. Data were synthesized thematically in narrative form. Ten hospital-based studies (n = 1,127) conducted at tertiary institutions and spanning multiple geopolitical zones in Nigeria were included. All were cohort studies (eight retrospective and two prospective) and reported a male predominance. Congenital hydrocephalus, most commonly attributed to aqueductal stenosis and Chiari II malformations, was more common in infants and young children (40–90% across studies), while post-infectious causes were more common in older children. Ventriculoperitoneal (VP) shunting was the predominant treatment modality, while endoscopic third ventriculostomy (ETV) was used in a few centers. Shunt infections were the most common complication, with rates ranging from 11% to 28%. Late presentation was reported with presentation ages ranging between 1 and 12 months of age. High out-of-pocket expenses, limited access to advanced imaging, lack of trained neurosurgeons, and sociocultural barriers to timely care were among the challenges encountered. Pediatric hydrocephalus in Nigeria is characterized by delayed presentation, limited treatment options, and geographical disparities in care. Although ETV is gaining popularity as a treatment modality, VP shunting remains the standard of care. To improve outcomes, neurosurgical services should be decentralized, community-level awareness enhanced, insurance coverage expanded, and national guidelines for hydrocephalus management established.