Factors Affecting the Development of Hydrocephalus in Patients with Spinal Neural Tube Defects

To identify the factors that could prevent the formation of spina bifida, and to determine the causes of hydrocephalus.

We retrospectively evaluated the data of 51 patients with neural tube defects (NTDs) who were surgically treated at Sanliurfa Training and Research Hospital between December 2021 and October 2022.

The mean maternal folate level was 7.02 ± 3.66 ?g/L. Of the 51 mothers, 14 (27.5%) had low folate levels and 37 (72.5%) had normal folate levels. The mean maternal vitamin B12 level was 287.29 ± 91.64 ng/L. Of the 51 mothers, 9 (17.6%) had low vitamin B12 levels and 42 (82.4%) had normal vitamin B12 levels. Ventriculoperitoneal shunt (VPS) surgery was performed in 19 (37.3%) of 51 patients. The area of NTD was significantly higher in infants who underwent VPS surgery due to hydrocephalus than in infants without hydrocephalus. The risk of developing hydrocephalus increased as the severity of NTD type increased. Furthermore, the risk of developing hydrocephalus increased in patients with NTDs at higher anatomical levels.

Although the optimum blood folate level for preventing MMC remains uncertain, the upper limit of the normal reference should be targeted. Hydrocephalus is an important cause of morbidity and mortality in patients with SB and its incidence is higher in patients with an anatomical higher NTD, a more severe type of NTD, and a large defect diameter. Furthermore, hydrocephalus is more common in patients with SM and female patients.