The effects of ventriculoperitoneal shunt on thyroid function in hydrocephalic newborns

Hydrocephalus and congenital hypothyroidism are the diseases leading to diffuse damage to brain parenchyma and often associated with other congenital anomalies cause many problems in terms of both the newborns and families and social environment.The aim of the this study is to investigate that effects of increased intracranial pressure due to hydrocephalus on hypothalamic-pituitary-tiroid axis and effects of ventriculoperitoneal shunt on tiroid functions in the first 3 months of the life.Twenty five hydrocephalic patients inserted ventriculoperitoneal shunt for hydrocephalus within the first 10 days of their life, and 20 control patients followed with congenital hypothyroidism but with borderline thyroid functions and given no medical therapy were included in this study. Blood samples were taken from both patients and control groups after 7th, 30th and 90th days of their life and evaluated and compared for levels of TSH, FT4, FT3. Hydrocephalic patients group's 7th day levels were evaluated before ventriculoperitoneal shunt operation.In terms of the levels of TSH and FT3 at 7th day, there was statistical significance between groups (p<0.05), at 30th day the difference between groups were found statistically significant for FT3 levels (p<0.05), the difference between groups for TSH levels at 90th was found statistically significant (p<0.05). When the correlation of TSH, FT4 and FT3 levels between groups was evaluated; the correlation between TSH and FT3 was found significant (r=0.334 and p=0.031). When patients' TSH levels were compared at 7th day according to and 30th, 90th days, statistically significancy were found in TSH levels normalisation (p<0.05).As a result, we think that the ventriculoperitoneal shunt restore cognitive functions and hypothalamic-pituitary axis dsfunction in circadian rhytym in the early period via decreasing brain edema, intracranial pressure and inflammation, in the late period via increasing myelination in hydrocephalus.Keywords: Hydrocephalus, Ventriculoperitoneal shunt, Congenital hypothyroidism, Thyroid hormone