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Updated: Jul 6, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Hydrocephalus-Associated Early Mortality in Myelomeningocele: A 22-Year Institutional Experience

Hasan Ali Aydin1, Emrah Keskin1, Murat Kalayci1

  • 1Department of Neurosurgery, School of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Türkiye.

World Neurosurgery
|April 6, 2026
PubMed
Abstract

Insights

Early deaths in myelomeningocele (MMC) primarily affect shunt-dependent patients within five years. Hydrocephalus may indicate vulnerability, not cause mortality, highlighting the need for early childhood surveillance.

Area of Science:

  • Pediatric Surgery
  • Neuroscience
  • Clinical Neurology

Background:

  • Myelomeningocele (MMC) is a severe congenital condition linked to significant early-life morbidity and mortality.
  • While hydrocephalus is common in MMC, its precise impact on early mortality requires further investigation in clinical cohorts.

Purpose of the Study:

  • To investigate early mortality patterns in myelomeningocele (MMC) patients.
  • To analyze the relationship between hydrocephalus, shunt complications, and survival over 22 years at a single center.

Main Methods:

  • Retrospective cohort study of 28 MMC patients undergoing surgical repair (2002-2024).
  • Data collected on demographics, hydrocephalus, ventriculoperitoneal (VP) shunt placement, shunt complications, and mortality.
  • Survival analysis using Kaplan-Meier methods; Fisher's exact test for group comparisons.

Main Results:

  • Overall mortality was 25% (7/28), with all deaths occurring within the first five years.
  • Hydrocephalus requiring VP shunt placement was present in 79% (22/28) of patients.
  • Mortality was exclusively observed in shunt-dependent patients (7/22), with most deaths linked to shunt complications (71%).

Conclusions:

  • Early mortality in MMC patients is concentrated within the first five years and occurs only in those requiring shunts.
  • Hydrocephalus may serve as an indicator of early vulnerability rather than a direct cause of mortality.
  • Continuous monitoring during early childhood is crucial for managing MMC patients.
Keywords:
Early-life mortalityHydrocephalusMyelomeningocelePediatric neurosurgeryShunt complicationsVentriculoperitoneal shunt

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