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. 2021 Nov;37(11):3407-3415.
doi: 10.1007/s00381-021-05333-2. Epub 2021 Aug 25.

Hydrocephalus in myelomeningocele

Sergio Cavalheiro  1   2 , Marcos Devanir Silva da Costa  3   4 , Mauricio Mendes Barbosa  5   6 , Patricia Alessandra Dastoli  1   2 , Jardel Nicácio Mendonça  1   2 , Daniela Cavalheiro  7 , Antonio Fernandes Moron  5
Affiliations

Hydrocephalus in myelomeningocele

Sergio Cavalheiro et al. Childs Nerv Syst. 2021 Nov.

Abstract

Purpose: To investigate certain aspects of hydrocephalus in patients with myelomeningocele.

Methods: We retrospectively analyzed data of 1050 patients with myelomeningocele who underwent surgical treatment between June 1991 and June 2021. These patients were divided into three groups: group 1 consisted of patients who underwent surgery after the first 6 h of life, group 2 consisted of patients who underwent surgery within the first 6 h, and group 3 consisted of patients who underwent surgery during the fetal period and before 26 6/7 weeks of gestation.

Results: There were 125, 590, and 335 patients in groups 1, 2, and 3, respectively. In groups 1 and 2, 593 (83%) patients developed hydrocephalus after birth and required ventriculoperitoneal shunt placement in the maternity ward, mainly within the first 4 days of life. In contrast, in group 3, 24 (7.2%) patients required surgery to treat hydrocephalus after birth. Hydrocephalus was the primary cause of mortality in groups 1 and 2, with mortality rates of 35% and 10%, respectively. In group 3, the mortality rate was 0.8% and was not related to hydrocephalus.

Conclusion: The onset of hydrocephalus is directly related to myelomeningocele closure in neurosurgery.

Keywords: Chiari type II; Fetal neurosurgery; Folates; Hydrocephalus; Myelomeningocele.

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