Acute hydrocephalus following acute polyradiculo- neuritis in pediatric patients: observation of 2 cases treated with ventriculoperitoneal shunt and systematic review of the literature

Background: Acute polyradiculoneuritis, or Guillain-Barré syndrome, is an immune-mediated disorder of the peripheral nerves that typically presents with ascending weakness. Central complications are rare in children, with acute communicating hydrocephalus being exceptionally uncommon. This form of hydrocephalus, caused by impaired CSF resorption despite preserved flow, can be fatal if untreated. To our knowledge, this is the first reported pediatric case of such a complication in Africa. Case report: We report two cases of children who were managed in the neurosurgery department for acute communicating hydrocephalus. Both had been treated a few days earlier in the pediatric neurology unit for acute polyradiculoneuritis. Each patient underwent ventriculoperitoneal (VP) shunt placement combined with medical therapy, resulting in favorable clinical outcomes. Conclusion: Acute hydrocephalus is a rare but serious complication of Guillain-Barré syndrome in children. It may be exacerbated by velopharyngeal paralysis, respiratory failure, and the limited ability of young children to articulate their symptoms. Early diagnosis and prompt surgical intervention, particularly VP shunting, are critical and potentially life-saving.