SLOW PREPUBERTAL LINEAR GROWTH BUT EARLY PUBERTAL GROWTH SPURT IN PATIENTS WITH SHUNTED HYDROCEPHALUS

Objective. To evaluate growth and to compare anthropometric measures a nd the degree of physical maturation in children with shunted hydrocep halus with those in healthy children. Methods. One hundred fourteen pa tients (62 male) and 73 healthy subjects (38 male) 5 to 20 years of ag e were analyzed for growth data and current auxology, stage of puberty , and bone age. Results. Boys with hydrocephalus were shorter than con trol boys during their first 8 years of age, and no catch-up growth wa s observed until puberty. Girls with hydrocephalus were of the same si ze at birth as the control girls, but their linear growth retarded dur ing the first years of life, leading to reduced relative height betwee n the age of 5 to 8 years. The pubertal growth spurt occurred earlier in boys with hydrocephalus (age at mid-growth spurt, 12.1 vs 13.3 year s), and a similar trend was seen in girls (10.0 vs 10.7 years). The fi nal height was again reduced, especially in boys. Patients with hydroc ephalus were more obese than control subjects, girls more often than b oys. Relative bone age was retarded in prepubertal (-0.42 vs 0.32 SD) and accelerated in pubertal patients (0.54 vs -0.19 SD). Conclusions. Children with hydrocephalus experience dow linear growth in prepuberty , but they have an earlier adolescent growth spurt. Together these fac tors result in a reduced final height. An increase in relative weight emerges in the preadolescent period, and this phenomenon is accentuate d after puberty, leading to an increased prevalence of obesity.