The Changing Panorama of Infantile Hydrocephalus and Cerebral Palsy Over Forty Years: A Swedish survey
Changes in the panorama of neurodevelopmental impairments in Sweden have been followed from birth years at the end of the 1940s. The birth incidence of infantile hydrocephalus (IH) for children born 1952–57 was 0.85 per 1000. The long-term survival before 1960 (the pre-shunting period) was low, particularly for IH babies born preterm. Among IH survivors multi-impairments were common, a special IH-syndrome impressive. A recent study covering children born 1967–82 showed a decreased total prevalence (0.53 per 1000 live births), and a markedly increased survival. Through the period there was an increase in prevalence, exclusively referrable to the preterm group. Among preterms the majority had their IH secondary to peripheral-neonatal intracranial hemorrhages. Among fullterms the origin of IH was prenatal in —70%, perinatal in ~25%, postnatal in 5%. CNS maldevelopments predominated in the prenatal group. Children with cerebral palsy (CP) from the late 1940s and early 1950s partly differed in type and origin compared to those of the actual period. Dyskinetic CP due to Kern-icterus successively disappeared in the beginning of the 1950s. Our present population-based CP series comprises 1000 children born 1954–82. The total prevalence decreased 1954–70 from 2.3 to 1.4 per 1000 live births, and mainly due to preterms with diplegia. From 1971 and onwards the CP prevalence, however, increased to 2.3 per 1000 (1979–82). Again, the changes mainly referred to the group of preterm CP diplegia, rising from 0.18 per 1000 in 1967–70 to 0.67 in 1979–82. A new group of CP infants born extremely preterm (GA>28 weeks) and severely multi-impaired now also had entered the scene.