Hydrocephalus project - Prof. Di Rocco & Choux
A significantly large hydrocephalic population does not have access to any neurosurgical facility. Neurosurgeons belonging to the Wfns should provide education of the local medical staff on a voluntary base. The adequate treatment of hydrocephalus can be implemented even in a still developing country.
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Hydrocephalus is considered to be the most prevalent and lethal CNS malformation in developing countries. Many aspects influence the outcome for these children: prevention, diagnosis, appropriate surgical treatment, and follow-up. Prof. Choux and Di Rocco, two well-known and worldwide acclaimed top Pediatric Neurosurgeons, have developed over the last years a fascinating and generous program on Pediatric Hydrocephalus for developing countries. Lectures, Hands-On Courses, and even building operating rooms take part in the actions of these two WFNS Honorary Presidents highly committed with Foundation goals. Dr. Ling Feng (China) is also taking part of this successful program.
Why is so important Pediatric hydrocephalus?
The management of hydrocephalus in its various forms and etiologies still represents a significant proportion of the neurosurgeons clinical practice. Nevertheless, too many affected subject still cannot benefit of a correct neurosurgical treatment in the world. A significantly large hydrocephalic population does not have access to any neurosurgical facility. Other affected patients can rely only on a limited and insufficient specific assistance Most of children with hydrocephalus are born in still developing countries where other medical problems do exist with a major social impact and concern because their major diffusion, namely malaria, TBC, tropical fevers, AIDS.. Though, this situation can account for the relatively low interest for a disease that involves 1-2% of children only, we can’t forget that a child whose hydrocephalus is not operated on is destined to die or to face a severe psychomotor retardation that will further weight their families and the medical/social care delivery in their countries. On the other hand, an operated on child may develop normally and exploit all its life potential.
Can Hydrocephalus Centers be implemented in developing countries?
On the grounds of previous experiences, it has been demonstrated that a center for the adequate treatment of hydrocephalus can be developed even in a still developing country provided that some pre-requisites do exist locally and an assistance is initially offered by international institutions, hospitals and private charity groups. Locally, it necessary to count on a governmental support, a medical facility to which the new center should be related, medical doctors and nurse personnel that are eager to participate. Among the international supporters, the WFNS Foundation is the natural promoter being able to supervise the project’s implementation and favor the acquisition of the necessary instrumentation (operating microscope, endoscope, surgical sets, CSF shunt devices) at an accessible cost. Neurosurgeons belonging to the WFNS should provide education of the local medical staff on a voluntary base. Private organizations should offer the necessary funds. Essentially for the success would be a perfect coordination among all the actors.
Can you give an example of such a pioneer centers?
A practical model for implementing the Hydrocephalus project supported by the WFNS Foundation is offered by the experience realized in Kirzigstan: Three actors: local medical authorities and doctors (in this case, the local pediatric national hospital of the capital town Bishek (National Center of Maternity and Childhood Care, international neurosurgical staff with WFNS involvement and direct participation of a foreign institution (International Neurosciences Institute) and charity organization (Stiftung Zuversicht für Kinder, Germany). The first step of the project was a solid evaluation of the local necessities and the analysis of potential favorable factors for a successful achievement through an hoc visit on site during which the local situation and the interest of the local doctors were tested. The second steps consisted of three further on site visits that were necessary for teaching the local doctors and nurses and operating on the first children. (The teaching neurosurgeons and nurses staff was provided by INI. Thanks to the Stiftung Zuversicht für Kinder, an operatory room was build and a microscope, an endoscope, a cranial neurosurgical instruments set were donated, acquired at a discounted price through the WFNS Foundation. This charity organization donated also an apparatus for anesthesia, an operating table plus 200 CSF shunt devices.Total cost: 215.000 $).
Some overview of the recent activities?
As expected Covid 20 pandemics impacted on the program of the Hydrocephalus Project and on the activities of the Hydrocephalus Subcommittee negatively actually resulting in the cancellation of all events planned for the current year after the month of February. Here is a summary of the activities.
Kiev. June, 2019. This course was the first approach of the Foundation to Ukraine to explore the scientific and practical management of hydrocephalus in the country. It was very well attended and provided the evidence of the serious limitations the local neurosurgeons have to face in their daily practice for the lack of technical equiments for the diagnosis and the surgical activity.
Silk Road Hospital Addis Ababa, Ethiopia. November, 2019. This course was intended to be the first of a series of courses aimed at establishing a center for the treatment of hydrocephalus (and other pediatric and adult neurosurgical diseases) in Addis Ababa, Ethiopia .Besides WFNS Foundation the course was supported by the Ethiopian Society of Neurosurgery and the Chinese government with the assistance of the Ling Feng Foundation.
Lyon. February, 2020. Hydrocephalus revisited SF disorders in the fetus neonates and infants; from diagnosis to treatment. In the last years the traditional concepts of CSF dynamics propounded by Dandy were challenged by experimental and clinical observation. The main aim of the course was to present and discuss the new model of CSF dynamics and their impact on hydrocephalus management. In this direction the representatives of the main CSF draining systems were invited to discuss the concepts at the base of their products and how they planned to respond to the new interpretation of hydrocephalus. Particular emphasis was given to the management of hydrocephalus in the first years of life with the plan to dedicate a second course to the older population (project currently in standby). The course enjoyed a large participation and an excellent international faculty.
Cairo. February, 2020. in the frame of the Pediatric Neurosurgery&Neuro-Oncology: Africa facing the Future). The course which was held in one of the best pediatric hospitals in Africa, was part of a program aimed at improving neurosurgical care for the pediatric population in Egypt and neighbouring countries. The attendance was quite large, A high scientific level was assured by the international faculty that shared the goals of the course providing excellent educational lectures.