Hydrocephalus in spina bifida

Morgado, Tiago Clemente; Figaji, Anthony

doi:10.7196/samj.8194

Cited by 2 publications

(8 citation statements)

References 18 publications

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“…However, it is not without complications. It is known to have a significant failure rate, particularly related to infective complications [10,19]. Furthermore, these children already have vulnerable CNS tissue and the development of additional infection further worsens cognitive function and other outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, these children already have vulnerable CNS tissue and the development of additional infection further worsens cognitive function and other outcomes. This has made the timing of VPS insertion an area of debate [19]. Whereas some authors suggest that VPS insertion at the same time or within a week of myelomeningocele closure increases the risk of shunt infection [10,15,20], others report no significant difference in the rate of shunt infection and dysfunction [21].…”

Section: Discussionmentioning

confidence: 99%

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A perspective in the management of myelomeningocoele in the KwaZulu-Natal Province of South Africa

2020

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Background Myelomeningocoele (MMC) is common in the developing world. The purpose of this study was to investigate the clinical characteristics and management of myelomeningocoele and to identify factors contributing to outcomes. Methods This was a retrospective, observational study of consecutive children diagnosed with MMC managed in the Paediatric Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. Multiple logistic regression analysis identified clinical characteristics, demographics and surgical variables that were associated with outcome. Results A total of 309 children were managed during this period (M:F 1.3:1). The most common sites were lumbar, lumbo-sacral and sacral. Mean age at surgical repair was 4.7 ± 15.6 months. Two hundred and eight children had ventriculomegaly, of whom 158 had symptomatic hydrocephalus, requiring CSF diversion. Fifty-eight (21%) patients developed wound sepsis, of whom 13 (22%) developed meningitis (p = 0.001). The time to wound sepsis was 9.5 ± 3.6 days. The commonest organism isolated was Staphylococcus aureus followed by MRSA. Thirty-two patients (23%) developed shunt malfunction and three (11%) developed ETV malfunction. Twenty children (9%) demised during the admission period. Death was associated with meningitis (p < 0.0001), and meningitis itself was associated with wound sepsis (p < 0.0001). Hospital stay was 20.4 ± 16 days. Wound sepsis (p = 0.002) and meningitis (p < 0.0001), respectively, were associated with prolonged hospital stay. Conclusion There was a slight male preponderance and hydrocephalus occurred in two thirds of cases. Wound sepsis and meningitis were associated poor outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A perspective in the management of myelomeningocoele in the KwaZulu-Natal Province of South Africa

2020

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“…Occipito-frontal circumference measurement is important because the patent fontanelles and calvarial sutures may mask overt signs of raised intracranial pressure due to increasing head size, though there may be significant pathology in the brain. When OFC crosses centiles or increases rapidly, surgical intervention is mostly indicated [11].…”

Section: Neonates and Infantsmentioning

confidence: 99%

“…It is easy to carry out, cheap, and widely available. It can assess ventricular size, evaluate other anatomic anomalies, and detect other pathologies such as intraventricular hemorrhage [11].…”

Section: Trans Fontanelle Ultrasoundmentioning

confidence: 99%

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Hydrocephalus Associated with Myelomeningocele

Adebayo¹

2023

Frontiers in Hydrocephalus

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Hydrocephalus (HCP) is one of the most common associations of myelomeningocele, and it may be overt and present at birth or be latent and develop following the repair of myelomeningocele. In patients with myelomeningocele, aqueductal stenosis, fourth ventricular obstruction, subarachnoid obstruction at the tentorial hiatus, and the crowded posterior fossa, which are all related to Chiari II malformation, are the various causes of hydrocephalus. The clinical manifestations depend on the age at presentation, but most patients present with macrocephaly and craniofacial disproportion, increasing head size, bulging anterior fontanelle, calvaria sutural diastasis, distended scalp veins, poor feeding as well as signs of raised intracranial pressure such as vomiting, headache, and altered consciousness. Diagnosis is based on clinical features and supportive radiological investigations such as transcranial ultrasound, brain computerized tomographic scan, and brain magnetic resonance imaging. Prompt treatment is very important to obtain optimal clinical outcomes, and this may be by inserting a shunt or performing endoscopic third ventriculostomy with or without choroid plexus cauterization.

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Hydrocephalus in spina bifida

Cited by 2 publications

References 18 publications

A perspective in the management of myelomeningocoele in the KwaZulu-Natal Province of South Africa

A perspective in the management of myelomeningocoele in the KwaZulu-Natal Province of South Africa

Hydrocephalus Associated with Myelomeningocele

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