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Natural history of hydrocephalus in children with spinal open neural tube defect

Essam A Elgamal1

  • 1Neurosurgery Division, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

Surgical Neurology International
|October 23, 2012
PubMed

Insights

Hydrocephalus is common in Spinal Open Neural Tube Defect (SONTD) patients, often linked to Chiari malformation type II. Early MRI and prompt treatment are crucial for managing SONTD-associated hydrocephalus.

Area of Science:

  • Pediatric Neurosurgery
  • Developmental Neuroscience
  • Clinical Neurology

Background:

  • Long-term prognosis for Spinal Open Neural Tube Defect (SONTD)-associated hydrocephalus remains poorly understood.
  • This study aimed to determine the incidence and natural history of hydrocephalus in SONTD patients.

Purpose of the Study:

  • To investigate the incidence and natural history of hydrocephalus in patients with SONTD.
  • To analyze the management and outcomes of hydrocephalus in SONTD patients.

Main Methods:

  • Retrospective study of 82 SONTD patients over 1-16 years.
  • Patients classified into groups with active, compensated, or no hydrocephalus.
  • Analysis of treatment timing, complications, and hydrocephalus status.

Main Results:

  • Hydrocephalus affected 72% of SONTD patients, frequently associated with Chiari malformation type II.
  • Ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) were primary treatments; VPS revision/replacement occurred in 19.6% due to complications.
  • No treatment was required for patients with compensated or no hydrocephalus during follow-up.

Conclusions:

  • Hydrocephalus is prevalent in SONTD patients with Myelomeningocele and Chiari malformation type II, necessitating close monitoring and timely intervention.
  • Routine brain and craniocervical junction MRI is recommended for SONTD patients to assess ventricular size and Chiari malformation type II.
Abstract

Keywords:
Chiari malformation type IIhydrocephalusmyelomeningocelespinal open neural tube defect

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