Is there a role in the central nervous system development for using corticosteroids to treat meningomyelocele and hydrocephalus?

Gualberto, I. José Nogueira; Medeiros, G. Araújo; Santos, Marcelo Volpon; Lopes, Luíza da Silva; Machado, Hélio Rubens; Sbragia, Lourenço

doi:10.1007/s00381-022-05615-3

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…The reported VPS rate for MMC with postnatal closure ranges from 60-80% [3,5,6,13,17,[23][24][25][26][27],…”

Section: Discussionmentioning

confidence: 99%

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Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

Hashimoto,

Irizato,

Takemoto

et al. 2024

Preprint

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Introduction Most myelomeningocele (MMC) cases exhibit ventriculomegaly or hydrocephalus, yet a comprehensive volumetric assessment of MMC intracranial structures is lacking. This study aims to provide baseline data on intracranial structural volume immediately after birth in postnatally repaired MMC infants. Methods In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal closure, utilizing head computer tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Comparative analysis with healthy controls (eight infants at 0 months) employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS). Results MMC infants exhibited significant differences compared to healthy cases in LVV (33.18 mL vs. 2.05 mL, p < 0.001), CPV (0.67 mL vs. 0.25 mL, p = 0.005), and PCFV (21.35 mL vs. 39.50 mL, p < 0.001), but not in ICV (407.50 mL vs. 418.15 mL, p = 0.25). Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS. Conclusion Postnatally repaired MMC infants showed significantly larger LVV and CPV, and smaller PCFV compared to healthy infants, providing crucial baseline data for volumetric evaluation. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.

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“…The reported VPS rate for MMC with postnatal closure ranges from 60-80% [3,5,6,13,17,[23][24][25][26][27],…”

Section: Discussionmentioning

confidence: 99%

“…Hindbrain herniation is believed to play a key role in inducing hydrocephalus through increased resistance to cerebral venous out ow or abnormalities in CSF absorption or ow [9,11,27,32]. Therefore, it is reasonable to infer that MMC induces small PCFV, leading to the enlargement of LVV and subsequent hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

Hashimoto,

Irizato,

Takemoto

et al. 2024

Preprint

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“…Anti-inflammatory medications: Corticosteroids may be utilized in patients with PTH to reduce cerebral edema, swelling, and inflammation. 24 Additionally, these medications may be taken either orally or intravenously. Apps such as CogniFit, Peak, and Lumosity have made homebased cognitive rehabilitation more accessible, aiding in addressing these deficits.…”

Section: Pharmacological Agentsmentioning

confidence: 99%

“…Anti‐inflammatory medications: Corticosteroids may be utilized in patients with PTH to reduce cerebral edema, swelling, and inflammation 24 . Additionally, these medications may be taken either orally or intravenously.…”

Section: Current Management Strategiesmentioning

confidence: 99%

Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies

Sanker,

Kundu,

El Kassem

et al. 2023

Health Science Reports

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BackgroundHydrocephalus or ventriculomegaly is a condition brought on by an overabundance of cerebrospinal fluid (CSF) in the ventricular system. The major contributor to posttraumatic hydrocephalus (PTH) is traumatic brain injuries (TBIs), especially in individuals with occupations set in industrial settings. A variety of criteria have been employed for the diagnosis of PTH, including the combination of neurological symptoms like nerve deficits and headache, as well as an initial improvement followed by a worsened relapse of altered consciousness and neurological deterioration, which is detected by computed tomography‐brain imaging that reveals gradual ventriculomegaly.AimIn this article, we discuss and summarize briefly the current understandings and advancements in the management of PTH.MethodsThe available literature for this review was searched on various bibliographic databases using an individually verified, prespecified approach. The level of evidence of the included studies was considered as per the Centre for Evidence‐Based Medicine recommendations.ResultsThe commonly practiced current treatment modality involves shunting CSF but is often associated with complications and recurrence. The lack of a definitive management strategy for PTH warrants the utilization of novel and innovative modalities such as stem cell transplantations and antioxidative stress therapies.ConclusionOne of the worst complications of a TBI is PTH, which has a high morbidity and mortality rate. Even though there hasn't been a successful method in stopping PTH from happening, hemorrhage‐derived blood, and its metabolic by‐products, like iron, hemoglobin, free radicals, thrombin, and red blood cells, may be potential targets for PTH hindrance and management. Also, using stem cell transplantations in animal models and antioxidative stress therapies in future studies can lower PTH occurrence and improve its outcome. Moreover, the integration of clinical trials and theoretical knowledge should be encouraged in future research projects to establish effective and updated management guidelines for PTH.

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Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

Hashimoto,

Irizato,

Takemoto

et al. 2024

Childs Nerv Syst

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Introduction Most myelomeningocele (MMC) cases present with ventriculomegaly or hydrocephalus, yet a comprehensive volumetric assessment of MMC intracranial structures is lacking. This study aimed to provide baseline data on intracranial structural volumes immediately after birth in MMC infants who underwent repair surgeries after birth (postnatal repair). Methods In this retrospective single-center study, we analyzed 52 MMC infants undergoing postnatal repair, utilizing head computed tomography scans at birth for volumetric assessment. Intracranial volume (ICV), lateral ventricles volume (LVV), choroid plexus volume (CPV), and posterior cranial fossa volume (PCFV) were measured. Hydrocephalus was classified into no hydrocephalus, progressive hydrocephalus, and hydrocephalus at birth. Comparative analysis employed the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis discriminated cases with and without ventriculoperitoneal shunt (VPS). Results The median values were 407.50 mL for ICV, 33.18 mL for LVV, 0.67 mL for CPV, and 21.35 mL for PCFV. Thirty-seven cases (71.15%) underwent VPS. ROC analysis revealed an LVV cut-off value of 6.74 mL for discriminating cases with and without VPS. Progressive hydrocephalus showed no significant difference in ICV but significantly larger LVV compared to no hydrocephalus. Hydrocephalus at birth demonstrated statistically larger ICV and LVV compared to the other two types. Conclusion Baseline volumetric data were provided, and volumetric analysis exhibited statistical differences among three hydrocephalus types. These findings enhance our understanding of intracranial volumetric changes in MMC, facilitating more objective assessments of MMC cases.

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Is there a role in the central nervous system development for using corticosteroids to treat meningomyelocele and hydrocephalus?

Cited by 3 publications

References 39 publications

Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies

Intracranial volumetric evaluation in postnatally repaired myelomeningocele infants

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