Review on myelomeningocele management and its current status in Saudi Arabia

Alnaami, Ibrahim; Alayad, Eman

doi:10.17712/nsj.2019.1.20180169

Cited by 5 publications

(3 citation statements)

References 47 publications

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“…Further risk was compounded in this case because of the inability to operate within 72 hours of delivery and medical concerns associated with prematurity. 8 , 9 Cases of extreme prematurity often present with a variety of problems requiring immediate attention, delaying MMC closure. 10 In our case, closure needed to wait until the infant was stabilized sufficiently to transport, and intervention was further delayed due to respiratory concerns and a spontaneous bowel perforation.…”

Section: Discussionmentioning

confidence: 99%

Postnatal myelomeningocele closure in smallest reported neonate: illustrative case

Mohis,

Cordeiro,

Larson

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Myelomeningocele (MMC) is the most serious form of spina bifida, a congenital defect in neural tube development. Defect closure in a patient with an extremely low birth weight presents unique challenges and risks; lower birth weight is associated with multiple organ system concerns, homeostasis is difficult, and local tissue is underdeveloped. To the authors’ knowledge, the present case is the lowest reported weight (490 g) for a neonate with postnatal MMC repair. OBSERVATIONS A preterm male with a prenatally diagnosed lumbosacral MMC and associated Chiari malformation type II was born at 23 weeks 1 day to a 29-year-old mother, gravidity 6 parity 4. The patient was medically stabilized and underwent MMC closure on day of life 5. His weight was 490 g at the time of this repair, and he did not have any surgical complications. At age 16 months, he underwent endoscopic third ventriculostomy with choroid plexus cauterization; he has not required any further hydrocephalus treatments since the last follow-up at 30 months of age. LESSONS To the authors’ knowledge, this case is the lowest birth weight ex utero MMC closure reported in the literature. Challenges of prematurity and size required appropriate preoperative stabilization, careful hemostasis and temperature regulation, and meticulous surgical technique.

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Section: Discussionmentioning

confidence: 99%

Postnatal myelomeningocele closure in smallest reported neonate: illustrative case

Mohis,

Cordeiro,

Larson

et al. 2024

Journal of Neurosurgery: Case Lessons

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“…The novel takes place in the 1960s during the Yemeni Civil War and revolves around the experience of a young boy, Yahya, whose grandmother takes him with her from a remote village close to Yemen so they can go to Mecca for Hajj. 8 The grandmother dies en route and the boy is left destitute. To survive, Yahya is forced to work despite his young age.…”

Section: Imminence Of Death In Khal's Work (1998-2019)mentioning

confidence: 99%

Death and Dying in the Fiction of Abdo Khal

Albalawi

2023

tpls

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The fiction of Abdo Khal has received critical treatments in the Arab world focusing on gender, sexuality, moral collapse, village life, and mores. However, Khal’s engagement with death in his novels has been overlooked. This study turns to the conception of death in Khal’s fiction to add to the scholarly understanding of how Saudi fiction tries to construct the subject of death. This research aims at showing the great potential of Arabic fiction to provide ways of investigating the death element as an unavoidable human reality and filling the void formed in Arabic studies by the lack of critical treatments of the subject of death.

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“…Treatment of MMC consisted of surgical closure of the spinal canal at birth as early as 72 hours after birth to reduce the risk of central nervous system infection and to improve outcomes, in addition to the lifelong supportive care (Alnaami and Alayad, 2019). Spina bifida patients require placement of ventriculoperitoneal (VP) shunts to prevent the neurologic and intellectual compromise that accompanies significant ventriculomegaly.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic impregnated and non antibiotic impregnated ventriculoperitoneal shunts in neonatal myelomeningocele associated with hydrocephalus, Is there a valuable difference?

Elfadle

Soliman²,

Elkheshin³

et al. 2022

Medicine Updates

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Background: Myelomeningocele (MMC) is a congenital defect of the central nervous system that inflicts a great burden on the patients and the healthcare system. Treatment of MMC involves placement of ventriculoperitoneal (VP) shunts for the associated hydrocephalus. The use of VP shunt is associated with potential complications such as shunt-related infections and shunt failures. The effectiveness of antibiotic-impregnated shunts to reduce the incidence of shunt infections is still debated.Objective: This study aimed to compare the outcomes following insertion of antibioticimpregnated versus nonantibiotic-impregnated ventricular and peritoneal shunts of the same type in cases of early postnatal surgical repair of myelomeningocele associated with hydrocephalus.Methods: Neonates presented after antenatal or after birth diagnosis of MMC, associated with clinical and radiological evidence of hydrocephalus, who were scheduled for early surgical intervention within 48 h after birth were included. Those with mild hydrocephalus, and full-thickness skin covering the MMC sac that can be managed as elective surgery were excluded. During surgery, patients were to either managed with antibiotic-impregnated both ventricular and peritoneal (VP) shunt (Group A, N= 12), or nonantibiotic-impregnated VP shunt of the same type (Group B, N=13). In both groups, the incidence of shunt infection and wound dehiscence, the type of wound management, duration of antibiotic prophylaxis, the need for a secondary procedure, operative time, and hospital stay were assessed. Results:The incidence of infection and partial wound dehiscence was non-significantly lower in group A than in group B (16.7% versus 30.8%, p=0.645). Two (16.7%) patients in group A required antibiotic use for more than 5 days compared with 4 (30.8%) patients in group B, with no significant difference (p=0.645). One patient in each group needed meticulous dressing and follow-up (8.3% versus 7.7%), whereas in between stitches and care was required in only 1 (8.3%) patient in group A compared with 3 (23.1%) patients in group B, with no significant difference. (p=0.787). Conclusions:The findings indicate comparable outcomes of antibiotic-impregnated shunts compared to nonantibiotic-impregnated ones. Compared with AIS, non-AIS showed a non-33 significant reduction in shunt and CSF infection rates, which was noted with the use of AI systems.

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Review on myelomeningocele management and its current status in Saudi Arabia

Cited by 5 publications

References 47 publications

Postnatal myelomeningocele closure in smallest reported neonate: illustrative case

Postnatal myelomeningocele closure in smallest reported neonate: illustrative case

Death and Dying in the Fiction of Abdo Khal

Antibiotic impregnated and non antibiotic impregnated ventriculoperitoneal shunts in neonatal myelomeningocele associated with hydrocephalus, Is there a valuable difference?

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