Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele.

Abstract

Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM). This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP) shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC), evaluation of fontanels, and measurement of lateral ventricular atrium (LVA) width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group), bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM.

• Authors: Jose Roberto Tude Melo, Pollyana Pacheco, Emília Nunes de Melo, Ângela Vasconcellos, Rosane Klein Passos
• Journal: Arquivos de neuro-psiquiatria (Arq Neuropsiquiatr) Vol. 73 Issue 9 Pg. 759-63 (Sep 2015) ISSN: 1678-4227 [Electronic] Germany
• PMID: 26352494 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Brazil (epidemiology)
• Cohort Studies
• Female
• Humans
• Hydrocephalus (diagnostic imaging, etiology, surgery)
• Infant, Low Birth Weight
• Infant, Newborn
• Infant, Premature
• Male
• Meningomyelocele (complications)
• Retrospective Studies
• Sensitivity and Specificity
• Ultrasonography
• Ventriculoperitoneal Shunt