7th Edition of Neurology World Conference 2027

Abstract

Abstract: Background: Symptoms such as headache, vomiting, and lethargy in patients with shunted hydrocephalus routinely prompt urgent evaluation for shunt malfunction, yet most of these evaluations do not confirm shunt failure. Caregivers and experienced surgeons have long reported that symptoms change with the weather, but this relationship has not been examined empirically. We investigated whether atmospheric pressure is associated with hydrocephalus-related hospital encounters. Methods: We performed a retrospective analysis of the daily hydrocephalus encounter census (emergency department visits and inpatient admissions; ICD-10 Q03.0, Q03.8, Q03.9) at Texas Children’s Hospital, Houston, from January 1, 2018 through December 31, 2022. Sea-level pressure (SLP) data from a single regional National Centers for Environmental Information station were aggregated to hourly means, from which daily maximum, minimum, mean, and standard deviation of SLP, maximum 8-hour SLP range, and maximum rate of change were derived. Univariable and multivariable Poisson generalized linear models, adjusted for day of week, month, and year, assessed associations between SLP measures and encounter counts on the same day and one and two days later. Results: The median daily census was 15 encounters (IQR 8–27). Median daily maximum SLP was 1018 hPa (IQR 1015–1022) and median maximum 8-hour SLP range was 4 hPa (IQR 4–5). In univariable analysis, encounters were associated with daily maximum rate of change and daily maximum, minimum, and mean SLP (all p<0.001), and these associations persisted at one- and two-day lags. In multivariable models, higher daily maximum SLP was associated with greater encounter volume on the same day (coefficient 0.01 per hPa, 95% CI 0.01–0.02, p<0.001), with the association persisting one and two days later (both p<0.001). A larger maximum 8-hour SLP range was inversely associated with encounter volume at all three time points (coefficient −0.02, 95% CI −0.03 to −0.01, p<0.001). Model fit was modest (R² 0.067–0.071). Conclusions: Atmospheric pressure is associated with daily hydrocephalus encounter volume at a tertiary children’s hospital, with effects extending up to two days. Although the effect sizes are modest and the findings do not establish causation, weather-related influences may warrant consideration when evaluating suspected shunt malfunction. Prospective studies pairing ambient pressure with telemetric intracranial pressure measurements are under way to test whether atmospheric changes directly affect intracranial pressure.