The Treatment of Hydrocephalus in Spina Bifida — Endoscopy

  • Benjamin Warf


Birth rates several times those in developed countries, the lack of preventive measures, and the rarity of prenatal diagnosis all contribute to the fact that spina bifida is a very common condition among children of developing countries. At the CURE Children’s Hospital of Uganda (CCHU), a center for pediatric neurosurgery established in 2001, 75–100 new infants with myelomeningocele (MMC) present for treatment annually.


Basilar Artery Spina Bifida Endoscopic Third Ventriculostomy Shunt Revision Shunt Malfunction 
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  1. 1.
    Drake JM, Kestle JR, Milner R et al (1998) Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery 43:294–305PubMedCrossRefGoogle Scholar
  2. 2.
    Sainte-Rose C, Piatt JH, Renier D et al (1991) Mechanical complications in shunts. Pediatr Neurosurg 17:2–9PubMedCrossRefGoogle Scholar
  3. 3.
    Tuli S, Drake J, Lamberti-Pasculli M (2003) Long-term outcome of hydrocephalus management in myelo — meningoceles. Childs Nerv Syst 19:286–291PubMedCrossRefGoogle Scholar
  4. 4.
    Steinbok P, Irvine B, Cochrane DD et al (1992) Longterm outcome and complications of children born with meningomyelocele. Childs Nerv Syst 8:92–96PubMedCrossRefGoogle Scholar
  5. 5.
    Warf BC (2005) Comparison of one — year outcomes for the Chhabra and Codman Hakim Micro Precision shunt systems in Uganda: A Prospective Study in 195 Children. J Neurosurg (Pediatrics 4) 102:358–362Google Scholar
  6. 6.
    Warf BC (2005) Hydrocephalus in Uganda: predominance of infectious origin and primary management with endoscopic third ventriculostomy. J Neurosurg (Pediatrics 1) 102:1–15Google Scholar
  7. 7.
    Pople IK, Ettles D (1995) The role of endoscopic choroid plexus coagulation in the management of hydrocephalus. Neurosurgery 36:698–702PubMedCrossRefGoogle Scholar
  8. 8.
    Laitt RD, Mallucci CL, Jaspan T et al (1999) Constructive interference in steady-state 3D Fourier-transform MRI in the management of hydrocephalus and third ventriculostomy. Neuroradiology 41(2):117–123PubMedCrossRefGoogle Scholar
  9. 9.
    Kurihara N, Takahashi S, Tamura H et al (2000) Investigation of hydrocephalus with three-dimensional constructive interference in steady state MRI. Neuroradiology 42(9):634–638PubMedCrossRefGoogle Scholar
  10. 10.
    Aleman J, Jokura H, Higano S et al (2001) Value of constructive interference in steady-state three-dimensional, Fourier transformation magnetic resonance imaging for the neuroendoscopic treatment of hydrocephalus and intracranial cysts. Neurosurgery 48(6):1291–1295PubMedCrossRefGoogle Scholar
  11. 11.
    Kadri H, Mawla AA (2004) Variations of endoscopic ventricular anatomy in children suffering from hydrocephalus associated with myelomeningocele. Minim Invas Neurosurg 47:339–341CrossRefGoogle Scholar
  12. 12.
    Jones RF, Kwok BC, Stening WA et al (1994) The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invas Neurosurg 37:28–36Google Scholar
  13. 13.
    Teo C, Jones R (1996) Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg 25:57–63PubMedCrossRefGoogle Scholar
  14. 14.
    Kadrian D, van Gelder J, Florida D et al (2005) Longterm reliability of endoscopioc third ventriculostomy. Neurosurgery 56:1271–1278PubMedCrossRefGoogle Scholar
  15. 15.
    Warf BC (2005) Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children. J Neurosurg (6 Suppl Pediatrics) 103:475–481Google Scholar
  16. 16.
    Warf BC, Campbell JW. Case report in preparationGoogle Scholar
  17. 17.
    Cinalli G, Spennato P, Ruggiero C et al (2006) Intracranial pressure monitoring and lumbar puncture after endoscopic third ventriculostomy in children. Neurosurgery 58:126–136PubMedCrossRefGoogle Scholar
  18. 18.
    Drake J, Chumas P, Kestle J et al (2006) Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature. J Neurosurg (2 Suppl Pediatrics) 105:118–126CrossRefGoogle Scholar
  19. 19.
    Dillon CM, Davis BE, Duguay S et al (2000) Longevity of patients born with myelomeningocele. Eur J Pediatr Surg 10(suppl 1):33–34PubMedGoogle Scholar
  20. 20.
    Marlin AE (2004) Management of hydrocephalus in the patient with myelomeningocele: an argument against third ventriculostomy. Neurosurg Focus 16(2):E4PubMedCrossRefGoogle Scholar
  21. 21.
    St George E, Natarajan K, Sgouros S (2004) Changes in ventricular volume in hydrocephalic children following successful endoscopic third ventriculostomy. Childs Nerv Syst 20:834–838PubMedCrossRefGoogle Scholar
  22. 22.
    van der Knaap MS, Valk J, Bakker CJ et al (1991) Myelination as an expression of the functional maturity of the brain. Dev Med Child Neurol 33:849–857PubMedGoogle Scholar
  23. 23.
    Hanlo PW (1995) Noninvasive intracranial pressure monitoring in infantile hydrocephalus and the relationship with transcranial Doppler, myelination and outcome. Thesis, Utrecht, The NetherlandsGoogle Scholar
  24. 24.
    Hanlo PW, Gooskens RJ, van Schooneveld M et al (1997) The effect of intracranial pressure on myelination and the relationship with neurodevelopment in infantile hydrocephalus. Dev Med Child Neurol 39(5):286–291PubMedCrossRefGoogle Scholar
  25. 25.
    Hanlo PW, Gooskens RH, Vandertop PW (2004) Hydrocephalus: intracranial pressure, Myelination, and neurodevelopment. In: Cinalli G, Maixner WJ, and Sainte-Rose C (eds) Pediatric hydrocephalus. Springer-Verlag Italia, Milan, pp 113–119Google Scholar
  26. 26.
    Horner E, Marchand S, Kaiser GL (2001) Ventricular and parenchymal surface before and after shunting-do they have prognostic value for outcome? Eur J Pediatr Surg 11(supp 1):S28–31PubMedCrossRefGoogle Scholar
  27. 27.
    Brown J, McLone D (1980) The effect of complications on intellectual function in 167 children with myelomeningocele. Z Kinderchir 34:17Google Scholar
  28. 28.
    McLone DG, Czyzewski D, Raimondi AJ et al (1982) Central nervous system infections as a limiting factor in the intelligence of children with myelomeningocele. Pediatrics 70:338–342Google Scholar
  29. 29.
    Di Rocco C, Massimi L, Tamburrini G (2006) Shunts vs. endoscopic third ventriculostomy in infants: are there different types and/or rates of complications?: A review. Childs Nerv Syst 22(12):1573–1589PubMedCrossRefGoogle Scholar
  30. 30.
    Casari EF, Fantino AG (1998) A longitudinal study of cognitive abilities and achievement status of children with myelomeningocele and their relationship with clinical types. Eur J Pediatr Surg 8(suppl 1):52–54PubMedCrossRefGoogle Scholar
  31. 31.
    Sgouros S, Kulkharni AV, Constantini S (2006) The international infant hydrocephalus study: concept and rationale. Childs Nerv Syst 22:338–345PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Benjamin Warf
    • 1
  1. 1.Department of NeurosurgeryA.I. Dupont Hospital for ChildrenWilmingtonUSA

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