ACCELERATED PUBERTAL DEVELOPMENT IN PATIENTS WITH SHUNTED HYDROCEPHALUS

Objective-To evaluate pubertal development and peripheral concentratio ns of gonadatrophins and sex hormones in children with shunted hydroce phalus compared with healthy controls. Study design-114 patients (52 f emales, 62 males) and 73 healthy controls (35 females, 38 males) aged 5 to 20 years were analysed far stage of puberty, ape at menarche, tes ticular volume, basal serum follicle stimulating hormone (FSH), lutein ising hormone (LH), sex hormone binding globulin (SHBG), testosterone and oestradiol concentrations, and free androgen index, Results-Male g onadal and male and female pubic hair development occurred significant ly earlier in the patients than in the controls. The mean age at menar che was significantly lower in the female patients than in their contr ols (11.7 v 13,2 years; p < 0.001), and lower than it had been for the ir mothers (v 13.1 years; p < 0.001). Relative testicular volume tvas higher in the male patients than in their controls (1.2 standard devia tion score (SDS) v 0.2 SDS; p < 0.001). The prepubertal patients had h igher basal LH (0.13 Un v 0.08 U/l; p < 0.001) and SHBG (132.3 nmol/l v 109.1 nmol/l; p < 0.01) than the controls. Both the prepubertal and pubertal females had significantly higher basal FSH than their control s (1.57 U/l v 1.03 Un; p < 0.05, and 4.0 Un v 2.9 Un; p < 0.01, respec tively). Conclusions-Hydrocephalic children experience accelerated pub ertal maturation, reflected in a younger age at menarche in females an d an increased testicular volume in males. This may be because of enha nced gonadotrophin secretion, possibly resulting front unphysiological variations in intracranial pressure,