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Progressive hydrocephalus in teenage spina bifida patients
Insights
Some spina bifida patients experience late-onset hydrocephalus, even without shunts. This study highlights a common cause for rising intracranial pressure (ICP) in both shunted and non-shunted individuals.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Developmental Biology
Background:
- Spina bifida patients with hydrocephalus often have shunts.
- Some patients appear shunt-independent but can develop late-onset hydrocephalus.
- Late-onset rising intracranial pressure (ICP) is a recognized but often overlooked complication.
Abstract:
Many spina bifida patients with shunts for hydrocephalus do not require shunt revisions for several years. These children are often considered to be no longer shunt dependent, only to develop rising intracranial pressure (ICP) requiring surgery in the second decade. We present three patients who, despite never having had a C.S.F. shunt, developed rising intracranial pressure in early teenage years. The diagnosis was delayed because of the lack of appreciation of this clinical entity. One child died, the second suffered permanent neurological damage, and the third recovered completely. We suggest that both shunted and non-shunted patients have a common cause for the late rise in ICP.