Skip to main content
SpringerLink
Log in

Hydrocephalus with Myelomeningocele

  • Chapter
Pediatric Hydrocephalus

Abstract

The incidence of myelomeningocele ranges between 0.2 and 2 per 1000 live births, with regional and racial variations [11]. The overall incidence of myelomeningocele has declined significantly in the last two decades, due to improved maternal nutrition during pregnancy with addition of folic acid and wider availability of prenatal diagnosis and therapeutic termination of pregnancy. The exact incidence of hydrocephalus in myelomeningocele is not known. In a significant proportion of patients hydrocephalus is absent at birth but develops in the first few weeks or months of life, indicating that there is a spectrum of manifestation [11]. Hydrocephalus is seen in postnatal neuroimaging obtained prior to closure of the defect in 15%–25% of children with myelomeningocele [11, 12], but in most surgical series the proportion of patients with myelomeningocele who require shunting reaches up to 8o%–90% (although inevitably there must be some sample bias in such series) [41, 59]. No obvious correlation between the level of the lesion and the presence of hydrocephalus has been shown [41,59].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andeweg J: Intracranial venous pressures, hydrocephalus and effects of cerebrospinal fluid shunts. Child’s Nerv Syst 5:318–323, 1989

    Article  CAS  Google Scholar 

  2. Babcock CJ, Goldstein RB, Barth RA, et al: Prevalence of ventriculomegaly in association with myelomeningocele: correlation with gestational age and severity of posterior fossa deformity. Radiology 190: 703–707, 1994

    Google Scholar 

  3. Bannister CM, Russell SA, Rimmer S: Pre-natal brain development of fetuses with a myelomeningocele. Eur J Pediatr Surg 8Suppl 1:15–17, 1998

    Article  PubMed  Google Scholar 

  4. Bier JA, Morales Y, Liebling J, et al: Medical and social factors associated with cognitive outcome in individuals with myelomeningocele. Dev Med Child Neurol 39: 263–266, 1997

    Article  PubMed  CAS  Google Scholar 

  5. Bourgeois M, Sainte-Rose C, Cinalli G, et al: Epilepsy in children with shunted hydrocephalus. J Neurosurg 90: 274–281, 1999

    Article  PubMed  CAS  Google Scholar 

  6. Brockmeyer D, Abtin K, Carey L, Walker ML: Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28:236–240, 1998

    Article  PubMed  CAS  Google Scholar 

  7. Bruner JP, Tulipan N, Paschall RL, et al: Fetal surgery for myelomeningocele and the incidence of shunt-dependent hydrocephalus. JAMA 282(19): 1819–1825, 1999

    Article  PubMed  CAS  Google Scholar 

  8. Caldarelli M, Di Rocco C, La Marca F: Shunt complications in the first postoperative year in children with meningomyelocele. Childs Nerv Syst 12:748–754, 1996

    PubMed  CAS  Google Scholar 

  9. Casari EF, Fantino AG: A longitudinal study of cognitive abilities and achievement status of children with myelomeningocele and their relationship with clinical types. Eur J Pediatr Surg 8Suppl 1:52–54, 1998

    Article  PubMed  Google Scholar 

  10. Dennis M, Fitz CR, Netley CT, et al: The intelligence of hydrocephalic children. Arch Neurol 38: 607–615, 1981

    Article  PubMed  CAS  Google Scholar 

  11. Dias MS: Myelomeningocele. In: Choux M, Di Rocco C, Hockley A, Walker M (eds) Pediatric neurosurgery. Churchill Livingstone, pp 33–59, 1999

    Google Scholar 

  12. Dias MS, McLone DG: Hydrocephalus in the child with dysraphism. Neurosurg Clin N Am 4:715–726, 1993

    PubMed  CAS  Google Scholar 

  13. Dillon CM, Davis BE, Duguay S, et al: Longevity of patients born with myelomeningocele. Eur J Pediatr Surg Suppl 1:33–34, 2000

    Article  Google Scholar 

  14. Donders J, Canady AI, Rourke BP: Psychometric intelligence after infantile hydrocephalus. Childs Nerv Syst 6: 148–154, 1990

    Article  PubMed  CAS  Google Scholar 

  15. Elias ER, Sadeghi-Nejad A: Precocious puberty in girls with myelodysplasia. Pediatrics 93:521–522, 1994

    PubMed  CAS  Google Scholar 

  16. Epstein NE, Rosenthal AD, Zito J, Osipoff M: Shunt placement and myelomeningocele repair: simultaneous vs. sequential shunting. Childs Nerv Syst 1:145–147, 1985

    Article  PubMed  CAS  Google Scholar 

  17. Gamache FW: Treatment of hydrocephalus in patients with meningomyelocele or encephalocele: a recent series. Childs Nerv Syst 11: 487–488, 1995

    Article  PubMed  Google Scholar 

  18. Geiger F, Parsch D, Carstens C: Complications of scoliosis surgery in children with myelomeningocele. Eur Spine J 8: 22–26, 1999

    Article  PubMed  CAS  Google Scholar 

  19. Hagberg B: The sequelae of spontaneously arrested infantile hydrocephalus. Develop Med Child Neurol 4:583–587, 1962

    Article  PubMed  CAS  Google Scholar 

  20. Hall P, Lindseth R, Campbell R, et al: Scoliosis and hydrocephalus in myelocele patients. The effect of ventricular shunting. J Neurosurg 50:174–178, 1979

    Article  PubMed  CAS  Google Scholar 

  21. Hammond MK, Milhorat TH, Baron IS: Normal pressure hydrocephalus in patients with myelomeningocele. Dev Med Child Neurol Suppl 37:55–68, 1976

    Google Scholar 

  22. Hubballah MY, Hoffman HJ: Early repair of myelomeningocele and simultaneous insertion of ventricu-loperitobeal shunt: technique and result. Neurosurgery 20:21–23, 1987

    Article  PubMed  CAS  Google Scholar 

  23. Hunt GM, Poulton A: Open spina bifida: a complete cohort reviewed 25 years after closure. Dev Med Child Neurol 37:19–29, 1995

    Article  PubMed  CAS  Google Scholar 

  24. Iborra J, Pages E, Cuxart A, et al: Increased intracranial pressure in myelomeningocele (MMC) patients never shunted: results of a prospective preliminary study. Spinal Cord 38:495–497, 2000

    Article  PubMed  CAS  Google Scholar 

  25. Jansen J: A retrospective analysis 21 to 35 years after birth of hydrocephalic patients born from 1946 to 1955. An overall description of the material and the criteria used. Acta Neurol Scand 71:436–447, 1985

    Article  PubMed  CAS  Google Scholar 

  26. Jamjoom AB, Khalaf NF, Mohammed AA, et al: Factors affecting the outcome of foetal hydrocephaly. Acta Neurochir (Wien) 140:1121–1125, 1998

    Article  CAS  Google Scholar 

  27. Jones RFC, Kwok BCT, Stening WA, Vonau M: The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invas Neurosurg 37: 28–36, 1994

    Article  CAS  Google Scholar 

  28. Jones RFC, Stening WA, Brydon M: Endoscopic third ventriculostomy. Neurosurgery 26: 86–92, 1990

    Article  PubMed  CAS  Google Scholar 

  29. Keucher TR, Mealey J: Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186, 1979

    Article  PubMed  CAS  Google Scholar 

  30. Laurence KM, Coates S: The natural history of hydrocephalus. Detailed analysis of 182 unoperated cases. Arch Dis Child 37:345–362, 1962

    Article  PubMed  CAS  Google Scholar 

  31. Lorber J: When is a shunt no longer necessary? An investigation of 300 patients with hydrocephaulus and meningomyelocele: 11–22 year follow-up. Z Kinderchir 34:327–329, 1981

    PubMed  CAS  Google Scholar 

  32. Martinez-Lage JF, Poza M, Lluch T: Craniosynostosis in neural tube defects: a theory on its pathogenesis. Surg Neurol 46:465–469, 1996

    Article  PubMed  CAS  Google Scholar 

  33. McCullough DC, Balzer-Martin LA: Current prognosis in overt neonatal hydrocephalus. J Neurosurg 57: 378–383, 1982

    Article  PubMed  CAS  Google Scholar 

  34. McCullough DC, Johnson DL: Myelomeningocele repair: technical considerations and complications. 1988. Pediatr Neurosurg 21:83–89; discussion 90, 1994

    Article  PubMed  CAS  Google Scholar 

  35. McDonnell GV, McCann JP: Why do adults with spina bifida and hydrocephalus die? A clinic-based study. Eur J Pediatr Surg 10Suppl 1:31–32, 2000

    Article  PubMed  Google Scholar 

  36. McLone DG: Care of the neonate with a myelomeningocele. Neurosurg Clin N Am 9:111–120, 1998

    PubMed  CAS  Google Scholar 

  37. McLone DG: Continuing concepts in the management of spina bifida. Pediatr Neurosurg 18: 254–256, 1992

    Article  PubMed  CAS  Google Scholar 

  38. McLone DG, Czyzewski D, Raimondi A, Sommers R: Central nervous system infections as a limiting factor in the intelligence of children with meningomyelocele. Pediatrics 70:338–342, 1982

    Google Scholar 

  39. McLone DC, Partington MD: An approach to the management of arrested and compensated hydrocephalus. Pediatr Neurosurg 19:101–103, 1993

    Article  PubMed  CAS  Google Scholar 

  40. Miller PD, Pollack IF, Pang D, Albright AL: Comparison of simultaneous versus delayed ventriculoperitoneal shunt insertion in children undergoing myelomeningocele repair. J Child Neurol 11:370–372, 1996

    Article  PubMed  CAS  Google Scholar 

  41. Mirzai H, Ersahin Y, Mutluer S, Kayahan A: Outcome of patients with meningomyelocele: the Ege University experience. Childs Nerv Syst 14:120–123, 1998

    Article  PubMed  CAS  Google Scholar 

  42. Morrow JD, Wachs TD: Infants with myelomeningocele: visual recognition memory and sensorimotor abilities. Dev Med Child Neurol 34:488–498, 1992

    Article  PubMed  CAS  Google Scholar 

  43. Naidich TP, Pudlowski RM, Naidich JB, et al: Computed tomographic signs of the Chiari II malformation Part I: Skull and dura partitions. Radiology 134: 65–71, 1980

    PubMed  CAS  Google Scholar 

  44. Naidich TP, Pudlowski RM, Naidich JB: Computed tomographic signs of Chiari II malformation II: Midbrain and cerebellum. Radiology 134:391–398, 1980

    PubMed  CAS  Google Scholar 

  45. Naidich TP, Pudlowski RM, Naidich JB: Computed tomographic signs of the Chiari II malformation III: Ventricles and cisterns. Radiology 134:657–663, 1980

    PubMed  CAS  Google Scholar 

  46. Naidich TP, McLone DG, Fulling KH: The Chiari II malformation: Part IV. The hindbrain deformity. Neuroradiology 25:179–197, 1983

    Article  PubMed  CAS  Google Scholar 

  47. Parent AD, McMillan T: Contemporaneous shunting with repair of myelomeningocele. Pediatr Neurosurg 22: 132–135; discussion 136, 1995

    Article  PubMed  CAS  Google Scholar 

  48. Pinar H, Tatevosyants N, Singer DB: Central nervous system malformations in a perinatal/neonatal autopsy series. Pediatr Dev Pathol 1:42–48, 1998

    Article  PubMed  CAS  Google Scholar 

  49. Proos LA, Dahl M, Ahlsten G, et al: Increased perinatal intracranial pressure and prediction of early puberty in girls with myelomeningocele. Arch Dis Child 75:42–45, 1996

    Article  PubMed  CAS  Google Scholar 

  50. Ransohoff J, Mathews ES: Neurosurgical management of patients with spina bifida and myelomeningocele. Med Clin North Am 53:493–496, 1969

    PubMed  CAS  Google Scholar 

  51. Riva D, Milani N, Giorgi C, et al: Intelligence outcome in children with shunted hydrocephalus of different etiology. Childs Nerv Syst 10:70–73, 1994

    Article  PubMed  CAS  Google Scholar 

  52. Rolle U, Gräfe G: About the rate of shunt complications in patients with hydrocephalus and myelomeningocele. Eur J Pediatr Surg 9Suppl 1:51–52, 1999

    PubMed  Google Scholar 

  53. Sainte-Rose C, Piatt JH, Renier D, et al: Mechanical complications of shunts. Pediatr Neurosurg 17:2–9, 1991

    Article  PubMed  Google Scholar 

  54. Saukkonen A-L, Serlo W, von Wendt L: Epilepsy in hydrocephalic children. Act Paediatr Scand 79:212–218, 1990

    Article  CAS  Google Scholar 

  55. Sgouros S, Malluci CL, Walsh AR, Hockley AD: Long term complications of hydrocephalus. Pediat Neurosurg 23:127–132, 1995

    Article  CAS  Google Scholar 

  56. Shurtleff DB: 44 years experience with management of myelomeningocele: presidential address, society for research into hydrocephalus and spina bifida. Eur J Pediatr Surg 10Suppl 1:5–8, 2000

    Article  PubMed  Google Scholar 

  57. Shurtleff DB, Foltz EL, Loeser JD: Hydrocephalus. A definition of its progression and relationship to intellectual function, diagnosis and complications. Am J Dis Child 125:688–693, 1973

    PubMed  CAS  Google Scholar 

  58. Steinbok P: Dysraphic lesions of the cervical spinal cord. Neurosurg Clin N Am 6: 367–376, 1995

    PubMed  CAS  Google Scholar 

  59. Steinbok P, Irvine B, Cochrane DD, Irwin BJ: Long-term outcome and complications of children born with meningomyelocele. Childs Nerv Syst 8:92–96, 1992

    Article  PubMed  CAS  Google Scholar 

  60. Strahl EW, Düchting M, Nahser C, Nau HE: Long-term follow-up studies in hydrocephalus patients with spina bifida or encephalocele. Adv Neurosurg 8: 247–251, 1980

    Article  Google Scholar 

  61. Sutton LN, Adzick NS, Bilaniuk LT, et al: Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele. JAMA 282:1826–1831, 1999

    Article  PubMed  CAS  Google Scholar 

  62. Swank M, Dias L: Myelomeningocele: a review of the orthopaedic aspects of 206 patients treated from birth with no selection criteria. Dev Med Child Neurol 34: 1047–1052, 1992

    Article  PubMed  CAS  Google Scholar 

  63. Talwar D, Baldwin MA, Horbatt CI: Epilepsy in children with meningomyelocele. Pediatr Neurol 13:29–32, 1995

    Article  PubMed  CAS  Google Scholar 

  64. Teo C, Jones R: Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg 25:57–63, 1996

    Article  PubMed  CAS  Google Scholar 

  65. Tulipan N, Bruner JP, Hernanz-Schulman M, et al: Effect of intrauterine myelomeningocele repair on central nervous system structure and function. Pediatr Neurosurg 31:183–188, 1999

    Article  PubMed  CAS  Google Scholar 

  66. Tulipan N, Hernanz-Schulman M, Bruner JP: Reduced hindbrain herniation after intrauterine myelomeningocele repair: A report of four cases. Pediatr Neurosurg 29: 274–278, 1998

    Article  PubMed  CAS  Google Scholar 

  67. Van Roost D, Solymosi L, Funke K: A characteristic ventricular shape in myelomeningocele-associated hydrocephalus? A CT stereology study. Neuroradiology 37: 412–417, 1995

    Article  PubMed  Google Scholar 

  68. Vogl D, Ring-Mrozik E, Baierl P, et al: Magnetic resonance imaging in children suffering spina bifida. Z Kinderchir 42(Suppl I): 60–64, 1987

    PubMed  Google Scholar 

  69. Wassing HE, Siebelink BM, Luyendijk W: Handedness and progressive hydrocephalus in spina bifida patients. Dev Med Child Neurol 35:788–797, 1993

    Article  PubMed  CAS  Google Scholar 

  70. Yashon D: Prognosis in infantile Hydrocephalus; past and present. J Neurosurg 20:105–111, 1963

    Article  PubMed  CAS  Google Scholar 

  71. Yeates KO, Enrile BG, Loss N, et al: Verbal learning and memory in children with myelomeningocele. J Pediatr Psychol 20: 801–815, 1995

    Article  PubMed  CAS  Google Scholar 

  72. Young HF, Nulsen FE, Weiss MH, Thomas P: The relationship of intelligence and cerebral mantle in treated infantile hydrocephalus. Pediatrics 52:38–44, 1973

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Birmingham Children’s Hospital, Birmingham, UK

    Spyros Sgouros

Authors
  1. Spyros Sgouros
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Pediatric Neurosurgery, Santobono-Pausilipon Children’s Hospital, Naples, Italy

    Giuseppe Cinalli MD

  2. Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Paris, France

    Christian Sainte-Rose MD

  3. Pediatric Neurosurgery, Royal Children’s Hospital, Melbourne, Australia

    Wirginia June Maixner MD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer-Verlag Italia

About this chapter

Cite this chapter

Sgouros, S. (2005). Hydrocephalus with Myelomeningocele. In: Cinalli, G., Sainte-Rose, C., Maixner, W.J. (eds) Pediatric Hydrocephalus. Springer, Milano. https://doi.org/10.1007/978-88-470-2121-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2121-1_9

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2173-0

  • Online ISBN: 978-88-470-2121-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation