Intracranial infection in patients with myelomeningocele: profile and risk factors
- 50 Downloads
To describe the profile and determine the risk factors for the development of intracranial infections (ICI) in paediatric patients with myelomeningocele (MMC).
Retrospective analysis of data from the records of patients with MMC admitted into our hospital between January 2006 and December 2015.
We managed a total of 688 paediatric non-trauma neurosurgical patients in our facility during the study period. 29.4% of these patients had MMC. We found the records for 49% of the patients. The male: female ratio was 1.3:1. Most of the MMCs were located in the lumbosacral region (71.7%). The lesion was ruptured in 42.4%, unruptured in 53.5%, and indeterminate in 4.0% of the patients. 48.5% of the MMCs were infected at presentation. Surgical repair of the spinal dysraphism was performed in 74.7% of the patients. Postoperative complications observed in our series include wound dehiscence, cerebrospinal fluid leak, and pseudomeningocele which occurred in 13.5%, 12.2%, and 2.7% of the operated cases of MMC respectively. 28.3% of the patients with MMC developed ICI during the course of hospitalization. 71.4% of patients with MMC-associated ICI had septic neural placode at the initial clinical evaluation. 70% of the patients who had wound dehiscence post-operatively developed ICI. Loculations and abscesses occurred only in patients who had surgical repair. A multivariate logistic regression analysis revealed that septic neural placode, hydrocephalus, a supra-lumbar location of the MMCs and surgical intervention were predictive of ICI (p < 0.05).
Infection of the neural placode, hydrocephalus, locations of the lesions above the lumbar region, and surgical repair were the statistically significant risk factors for ICI in our study population. The trending but statistically insignificant risk factors for ICI in our series may require further assessment with a larger sample size.
KeywordsSpina bifida cystica Meningitis Ventriculitis Spinal dysraphism
Compliance with ethical standards
Conflict of interest
The author declares that they have no conflict of interest.
- 7.Rennie JM (1999) Central nervous system malformation. In: Rennie JM, Roberton MRC (eds) Textbook of neurology, 3rd edn. Churchill Livingstone, Edinburgh, pp 1297–1311Google Scholar
- 10.Food and Drug Administration (1996) Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Fed Register 61:8781–8797Google Scholar
- 18.Uba AF, Isamade ES, Chirdan LB, Edino ST, Ogbe ME, Igun GO (2004) Epidemiology of neural tube defects in north Central Nigeria. Afr J Paediatr Surg 1:16–19Google Scholar
- 20.Katikar DB, Jaykar RD, Kamble M, Agrawal S (2014) Study of surgical intervention in patient of Meningocele with hydrocephalus: simultaneous V/S sequential group. Int J Recent Trends Sci Technol 11:17–24Google Scholar
- 21.Haslam RHA (2000) Congenital anomalies of the central nervous system. In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson textbook of pediatrics, 16th edn. WB Saunders Co, Philadelphia, pp 1803–1810Google Scholar
- 22.Hashim SM, Ahmed S, Jooma R (2008) Management of myelomeningocele. J Surgery Pakistan 13:7–11Google Scholar
- 23.Halaby WE, Ismail MT (2016) Delayed hydrocephalus after repairing un- rupture Myelomeningocele. Egypt J Neurosurg 31:167–170Google Scholar