Skip to main content
SpringerLink
Log in

Hydrocephalus Associated with Myelomeningocele

  • Reference work entry
  • First Online:
Textbook of Pediatric Neurosurgery

  • 97 Accesses

Abstract

Most of the features which characterize the hydrocephalus associated with myelomeningocele (MMC) were already pointed out in late 1970s of the last century such as, for example, its high incidence and its adverse prognostic significance in terms of intellectual development and survival as well as its multifactorial and complex pathophysiology (Stein and Schut 1979).

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 949.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,299.99
Price excludes VAT (USA)
  • Durable hardcover 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

References

  • Arslan M, Eseoglu M, Gudu BO, Demir I, Kozan A, Gokalp A, Sosuncu E, Kiymaz N (2011) Comparison of simultaneous shunting to delayed shunting in infants with myelomeningocele in terms of shunt infection rate. Turk Neurosurg 21(3):397–402

    PubMed  Google Scholar 

  • Beems T, Grotenhuis JA (2002) Is the success rate of endoscopic third ventriculostomy age dependent? An analysis of the results of third ventriculostomy in young children. Childs Nerv Syst 18:605–608

    PubMed  Google Scholar 

  • Bell WO, Arbit E, Fraser RA (1987) One-stage meningomyelocele closure and ventriculoperitoneal shunt placement. Surg Neorol 27(3):233–236

    CAS  Google Scholar 

  • Bowman RM, Mc Lone DG, Grant JA, Tomita T, Ito JA (2001) Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg 34(3):114–120

    CAS  PubMed  Google Scholar 

  • Bruner JP, Tulipan N, Paschall RL, Boehm FH, Walsh WF, Silva SR, Hernanz-Schulman M, Lowe LH, Reed GW (1999) Fetal surgery for myelomeningocele and the incidence of shunt-dependent hydrocephalus. JAMA 282(19):1819–1825

    CAS  PubMed  Google Scholar 

  • Bruner JP, Tulipan N, Reed G, Davis GH, Bennett K, Luker KS, Dabrowiak ME (2004) Intrauterine repair of spina bifida: preoperative predictors of shunt-dependent hydrocephalus. Am J Obstet Gynecol 190(5):1305–1312

    PubMed  Google Scholar 

  • Bruner JP, Davis G, Tulipan N (2006) Intrauterine shunt for obstructive hydrocephalus – still not ready. Fetal Diagn Ther 21(6):532–539

    PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  • Castellino RA, Zatz LM, De Nardo GL (1969) Radioisotope ventriculography in the Arnold-Chiari malformation. Radiology 93(4):817–821

    CAS  PubMed  Google Scholar 

  • Chadduck WM, Reding DL (1988) Experience with simultaneous ventriculo-peritoneal shunt placement and myelomeningocele repair. J Pediatr Surg 23(10):913–916

    CAS  PubMed  Google Scholar 

  • Chakraborty A, Crimmins D, Hayward R, Thompson D (2008) Toward reducing shunt placement rates in patients with myelomeningocele. J Neurosurg Pediatr 1:361–365

    PubMed  Google Scholar 

  • Cinalli G (2004) Endoscopic third ventriculostomy. In: Cinalli G, Maixner WJ, Sainte-Rose C (eds) Pediatric hydrocephalus. Springer, Milan, pp 361–388

    Google Scholar 

  • Clemmensen D, Rasmussen MM, Mosdal C (2010a) A retrospective study of infections after primary VP shunt placement in the newborn with myelomeningocele without prophylactic antibiotics. Childs Nerv Syst 26:1517–1521

    PubMed  Google Scholar 

  • Clemmensen D, Rasmussen MM, Mosdal C (2010b) A retrospective study of infections after primary VP shunt placement in the newborn with myelomeningocele without prophylactic antibiotics. Childs Nerv Syst 26:1517–1521

    PubMed  Google Scholar 

  • Cohen AR, Robinson S (2001) Early management of myelomeningocele. In: McLone DG (ed) Pediatric neurosurgery, 4th edn. W.B. Saunders, Philadelphia, pp 241–259

    Google Scholar 

  • Di Rocco C, Rende M (1987) Neural tube defects. Some remarks on the possible role of glycosaminoglycans in the genesis of the dysraphic state, the anomaly in the configuration of the posterior cranial fossa, and hydrocephalus. Childs Nerv Syst 3(6):334–341

    PubMed  Google Scholar 

  • Di Rocco C, Cinalli G, Massimi L, Spennato P, Cianciulli E, Tamburrini G (2006) Endoscopic third ventriculostomy in the treatment of hydrocephalus in pediatric patients. Adv Tech Stand Neurosurg 31:119–219

    PubMed  Google Scholar 

  • Dirks PB, Drake JM, Lamberti-Pasculli M, Rutka JT, Humphreys RP, McDonald P (2003) Falling ventriculoperitoneal shunt rates in myelomeningocele. Childs Nerv Syst 19:607

    Google Scholar 

  • Elgamal EA (2012) Natural history of hydrocephalus in children with spinal open neural tube defect. Surg Neurol Int 3:112

    PubMed  PubMed Central  Google Scholar 

  • Epstein NE, Rosenthal AD, Zito J, Osipoff M (1985) Shunt placement and myelomeningocele repair: simultaneous vs sequential shunting. Review of 12 cases. Childs Nerv Syst 1:145–147

    CAS  PubMed  Google Scholar 

  • Fitsch MJ, Mehdorn HM (2003) Indication and controversies for endoscopic third ventriculostomy in children. Childs Nerv Syst 19(9):706–707

    Google Scholar 

  • Fukuhara T, Vorster SJ, Luciano MG (2000) Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 46:1100–1111

    CAS  PubMed  Google Scholar 

  • Genitori L, Peretta P, Mussa F, Giordano F (2004) Endoscopic third ventriculostomy in children: are age and etiology of hydrocephalus predictive factors influencing the outcome in primary and secondary treated patients? A series of 328 patients and 353 procedures. II CURAC Congress, Munich, 8 Oct

    Google Scholar 

  • Hubballah MY, Hoffma HJ (1987) Early repair of myelomeningocele and simultaneous insertion of ventriculoperitoneal shunt: technique and results. Neurosurgery 20(1):21–23

    CAS  PubMed  Google Scholar 

  • Hunt GM, Oakeshott P, Kerry S (1999) Link between the CSF shunt and achievement in adults with spina bifida. J Neurol Neurosurg Psychiatry 67(5):591–595

    CAS  PubMed  PubMed Central  Google Scholar 

  • Iskandar BJ, Tubbs S, Mapstone TB, Grabb PA, Bartolucci AA, Oakes WJ (1998) Death in shunted hydrocephalic children in the 1990s. Pediatyr Neurosurg 28:173–176

    CAS  Google Scholar 

  • Januschek E, Roehrig A, Kunze S, Fremerey C, Wiebe B, Messing-Juenger M (2016) Myelomeningocele – a single institute analysis of the years 2007 to 2015. Unofficial paper, still not published

    Google Scholar 

  • Jenskinson MD, Hayhurst C, Al-Jumaily M, Kandasamy J, Clark S, Mallucci CL (2009) The role of endoscopic third ventriculostomy in adult patients with hydrocephalus. J Neurosurg 110(5):861–866

    Google Scholar 

  • Jones RF, Kwok BC, Stening WA, Vonau M (1996) Third ventriculostomy for hydrocephalus associated with spinal dysraphism: indications and contraindications. Eur J Pediatr Surg 6(Suppl 1):5–6

    PubMed  Google Scholar 

  • Kadri H, Mawla AA (2004) Variations of endoscopic ventricular anatomy in children suffering from hydrocephalus associated with myelomeningocele. Minim Invasive Neurosurg 47(6):339–341

    CAS  PubMed  Google Scholar 

  • Kestle JR, Walker ML, Investigators S (2005) A multicenter prospective cohort study of the strata valve for the management of hydrocephalus in pediatric patients. J Neurosurg 102(2 Suppl):141–145

    Google Scholar 

  • Koch D, Wagner W (2004) Endoscopic third ventriculostomy in infants of less than 1 year of age: which factors influence the outcome? Childs Nerv Syst 20:405–411

    PubMed  Google Scholar 

  • Kwick SJ, Mandera M, Bazowski P, Luszawski J, Duda I, Wolwender A, Yzmon-Zagorska A, Grzybowska K (2003) Endoscopic third ventriculostomy for hydrocephalus: early and late efficacy in relation to etiology. Acta Neuroshir 145:181–184

    Google Scholar 

  • Machado HR, de Oliveira RS (2004) Simultaneous repair of myelomeningocele and shunt insertion. Childs Nerv Syst 20:107–109

    PubMed  Google Scholar 

  • Massimi L, Paternoster G, Fasano T, Di Rocco C (2009) On the changing epidemiology of hydrocephalus. Childs Nerv Syst 25(7):795–800

    PubMed  Google Scholar 

  • Mc Lone DG, Dias MS (2003) The Chiari II malformation: cause and impact. Childs Nerv Syst 19(7–8):540–550

    Google Scholar 

  • Mc Lone D, Knepper PA (1989) The cause of Chiari II malformation: a unified theory. Pediatr Neurosci 15:1–12

    CAS  Google Scholar 

  • Mc Lone DG, Czyzewski D, Raimondi AJ, Sommers RC (1982) Central nervous system infections as a limiting factor in the intelligence of children with myelomeningocele. Pediatrics 70:338–342

    Google Scholar 

  • Miller PD, Pollack IF, Pang D, Albright AL (1996) Comparison of simultaneous versus delayed ventriculoperitoneal shunt insertion in children undergoing myelomeningocele repair. J Child Neurol 11(5):370–372

    CAS  PubMed  Google Scholar 

  • Mirzai H, Ersahin Y, Mutluer S, Kayahan A (1998) Outcome of patients with meningomyelocele: the Ege University experience. Childs Nerv Syst 14(3):120–123

    CAS  PubMed  Google Scholar 

  • Mori H, Oi S, Nonaka Y, Tamogami R, Muroi A (2008) Ventricular anatomy of hydrocephalus associated with myeloschisis and endoscopic third ventriculostomy. Childs Nerv Syst 24(6):717–722

    PubMed  Google Scholar 

  • Murshid WR (2000) Endoscopic third ventriculostomy: towards more indications for the treatment of non-communicating hydrocephalus. Minim Invas Neurosurg 43:75–82

    CAS  Google Scholar 

  • Nejat F, Tajik P, El Khashab M, Kazmi SS, Khotaei GT, Salahesh S (2008) A randomized trial of ceftriaxone versus trimethoprim-sulfamethoxazole to prevent ventriculoperitoneal shunt infection. J Microbiol Immunol Infect 41(2):112–117

    CAS  PubMed  Google Scholar 

  • O’Hayon BB, Drake JM, Ossip MG, Tuli S, Clarke M (1998a) Frontal and occipital horn ratio: a linear estimate of ventricular size for multiple imaging modalities in pediatric hydrocephalus. Pediatr Neurosurg 29(5):245–249

    PubMed  Google Scholar 

  • O’Hayon BB, Drake JM, Ossip MG et al (1998b) Frontal and occipital horn ratio: a linear estimate of ventricular sizes for multiple imaging modalities in pediatric hydrocephalus. Pediatr Neurosurg 29:245–249

    PubMed  Google Scholar 

  • Oi S, Di Rocco C (2006) Proposal of “evolution theory in cerebrospinal fluid dynamics” and minor pathway hydrocephalus in developing immature brain. Childs Nerv Syst 22(7):662–669

    PubMed  Google Scholar 

  • Oktem IS, Menkü A, Ozdemir A (2008) When should ventriculoperitoneal shunt placement be performed in cases with myelomeningocele and hydrocephalus? Turk Neurosurg 18(4):387–391

    PubMed  Google Scholar 

  • Pang D (1995) Surgical complications of open spinal dysraphism. Neurosurg Clin N Am 6(2):243–257

    CAS  PubMed  Google Scholar 

  • Parent AD, McMillan T (1995) Contemporaneous shunting with repair of myelomeningocele. Pediatr Neurosurg 22(3):132–136

    CAS  PubMed  Google Scholar 

  • Paretta P, Ragazzi P, Galarza M, Genitori L, Giordano F, Mussa F, Cinalli G (2006) Complications and pitfalls of neuroendoscopic surgery in children. J Neurosurg 105(3 Suppl):187–193

    Google Scholar 

  • Pavez A, Salazar C, Rivera R, Contreras J, Orellana A, Guzman C, Iribarren O, Hernandez H, Elzo J, Moraga D (2006) Description of endoscopic ventricular anatomy in myelomeningocele. Minim Invasive Neurosurg 49(3):161–167

    CAS  PubMed  Google Scholar 

  • Portillo S, Zuccaro G, Fernandez-Molina A, Houssay A, Sosa F, Konsol O, Jaimovich R, Olivella E, Ledesma J, Guevara M, Ajler G, Picco P (2004) Endoscopic third ventriculostomy in the treatment of pediatric hydrocephalus. A multicentric study. Childs Nerv Syst 20(8–9):666–667

    Google Scholar 

  • Radmanesh F, Nejat F, El Kashab M, Ghodsi SM, Ardebili HE (2009) Shunt complications in children with myelomeningocele: effect of timing of shunt placement. J Neurosurg Pediatr 3:516–520

    PubMed  Google Scholar 

  • Rintoul NE, Sutton LN, Hubbard AM, Cohen B, Melchionni J, Pasquariello PS, Adzick NS (2002) A new look of myelomeningoceles: functional level, vertebral level, shunting, and the implications for fetal intervention. Pediatrics 109(3):409–413

    PubMed  Google Scholar 

  • Russell DS (1966) Observation on the pathology of hydrocephalus. Her Majesty’s Stationary Office, London, pp 21–37

    Google Scholar 

  • Sgouros S (2004) Hydrocephalus with myelomeningocele. In: Cinalli G, Meixner W, Sainte-Rose C (eds) Pediatric hydrocephalus. Springer, Milan, pp 133–144

    Google Scholar 

  • Stein SC, Schut L (1979) Hydrocephalus in myelomeningocele. Childs Brain 5(4):413–419

    CAS  PubMed  Google Scholar 

  • Steinbok P, Irvine B, Cochrane DD, Irwin BJ (1992) Long-term outcome and complications of children born with meningomyelocele. Childs Nerv Syst 8(2):92–96

    CAS  PubMed  Google Scholar 

  • Stevenson KL (2004) Chiari type II malformation: past, present, and future. Neurosurg Focus 16(2):E5

    PubMed  Google Scholar 

  • Sutton LN, Adzick NS, Bilaniuk LT, Johnson MP, Crombleholme TM, Flake AW (1999) Improvement in hindbrain herniation demonstrated by serial fetal magnetic resonance imaging following fetal surgery for myelomeningocele. JAMA 282(19):1826–1831

    CAS  PubMed  Google Scholar 

  • Tamburrini G, Calderelli M, Massimi L, Ramirez-Reyes G, Di Rocco C (2004) Primary and secondary third ventriculostomy in children with hydrocephalus and myelomeningocele. Childs Nerv Syst 20(8–9):666

    Google Scholar 

  • Tamburrini G, Frassanito P, Iakovaki K, Pignotti F, Rendeli C, Murolo D, Di Rocco C (2013) Myelomeningocele: the management of the associated hydrocephalus. Childs Nerv Syst 29:1569–1579

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  • Tortori-Donati P, Rossi A, Cama A (2000) Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 42(7):471–491

    CAS  PubMed  Google Scholar 

  • Tubbs RS, Oakes WJ (2004) Treatment and management of the Chiari II malformation: an evidence-based review of the literature. Childs Nerv Syst 20(6):375–381

    Google Scholar 

  • Tuli S, Drake J, Lawless J, Wigg M, Lamberti-Pasculli M (2000) Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 92(1):31–38

    CAS  PubMed  Google Scholar 

  • Tuli S, Drake J, Lamberti-Pasculli M (2003) Long-term outcome of hydrocephalus management in myelomeningoceles. Childs Nerv Syst 19(5-6):286–291

    PubMed  Google Scholar 

  • Tulipan N, Hernanz-Schulman M, Lowe LH, Bruner JP (1999) Intrauterine myelomeningocele repair reverses preexisting hindbrain herniation. Pediatr Neurosurg 31(3):137–142

    CAS  PubMed  Google Scholar 

  • Tulipan N, Sutton LN, Bruner JP, Cohen BM, Johnson M, Adzick NS (2003) The effect of intrauterine myelomeningocele reapir on the incidence of shunt-dependent hydrocephalus. Pediatr Neurosurg 38(1):27–33

    PubMed  Google Scholar 

  • Wakhlu A, Ansari NA (2004) The prediction of postoperative hydrocephalus in patients with spina bifida. Childs Nerv Syst 20(2):104–106

    PubMed  Google Scholar 

  • Walker DG, Coyne TJ, Kahler RJ, Tomlinson FH (2003) Failure of endoscopic third ventriculostomy in myelomeningocele patients: preoperative clinical and radiological features. Childs Nerv Syst 19(9):707–708

    Google Scholar 

  • Walsh DS, Adzick NS, Sutton LN, Johnson MP (2001) The rationale for in utero repair of myelomeningocele. Fetal Diagn Ther 16:312–322

    CAS  PubMed  Google Scholar 

  • Warf BC (2011) Hydrocephalus associated with neural tube defects: characteristics, management and outcome in sub-Saharan Africa. Childs Nerv Syst 27:1589–1594

    Google Scholar 

  • Warf BC, Campbell JW (2008) Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: long-term results of a prospective intent-to-treat study in 115 East African infants. J Neurosurg Pediatr 2(5):310–316

    PubMed  Google Scholar 

  • Warf B, Ondoma S, Kulkarni A, Donnelly R, Ampeire M, Akona J, Kabachelor CR, Mulondo R, Nsubuga BK (2009) Neurocognitive outcome and ventricular volume in children with myelomeningocele treated for hydrocephalus in Uganda. J Neurosurg Pediatr 4(6):564–570

    PubMed  Google Scholar 

  • Williams H (2008) A unifying hypothesis for hydrocephalus, Chiari malformation, syringomyelia, anencephaly and spina bifida. Cerebrospinal Fluid Res 5:7

    PubMed  PubMed Central  Google Scholar 

  • Young HF, Nulsen FE, Weiss MH et al (1973) The relationship of intelligence and cerebral mantle in treated infantile hydrocephalus. Pediatrics 52:38–44

    CAS  PubMed  Google Scholar 

  • Zambelli H, Carelli E, Honorato D, Marba S, Coelho G, Carnevalle A, Iscaife A, da Silva E, Barini R, Sbragia L (2007) Assessment of neurosurgical outcome in children prenatally diagnosed with myelomeningocele and development of a protocol for fetal surgery to prevent hydrocephalus. Childs Nerv Syst 23(4):421–425

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurosurgical Department, Clinical Center of Serbia, Belgrade, Serbia

    Radovan M. Mijalcic

Authors
  1. Radovan M. Mijalcic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Radovan M. Mijalcic .

Editor information

Editors and Affiliations

  1. Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children, NHS Trust, London, UK

    Dachling Pang

  3. Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada

    James T. Rutka

Section Editor information

  1. Director of Pediatric Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Concezio Di Rocco

  2. Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School, Rome, Italy

    Gianpiero Tamburrini

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Mijalcic, R.M. (2020). Hydrocephalus Associated with Myelomeningocele. In: Di Rocco, C., Pang, D., Rutka, J. (eds) Textbook of Pediatric Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72168-2_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72168-2_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72167-5

  • Online ISBN: 978-3-319-72168-2

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation