title: Endoscopic Third Ventriculostomy in Children with Myelomeningocele: A Case Series.
abstract: Hydrocephalus develops in up to 80-90% of children with myelomeningocele (MM) after closure of the defect. Traditionally, ventriculoperitoneal shunts have been used to manage hydrocephalus in these patients. A role for endoscopic third ventriculostomy (ETV) in MM has provoked much debate, principally due to anatomical variants described, which may complicate the procedure. We present 7 cases of children with MM and hydrocephalus undergoing a total of 10 ETV procedures. All patients demonstrated clinical improvement (in acute/subacute cases) or stabilization (in chronic cases). Three patients requiring a second ETV have shown clinical stability and renewed radiological evidence of functioning ventriculostomies in follow-up since reintervention. ETV can be used, albeit cautiously, in selected cases of hydrocephalus associated with MM. However, the frequency with which anatomical variation is encountered and the difficulty of the assessment of success make the procedure more challenging than usual.
authors.affiliation: Pediatric Neurosurgery Unit, Carlos Haya Hospital, Malaga, Spain.
authors.forename: Sandra
authors.initials: S
authors.lastname: Perez da Rosa
authors.forename: Christopher Paul
authors.initials: CP
authors.lastname: Millward
authors.forename: Vanessa
authors.initials: V
authors.lastname: Chiappa
authors.forename: Maria
authors.initials: M
authors.lastname: Martinez de Leon
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ibáñez Botella
authors.forename: Bienvenido
authors.initials: B
authors.lastname: Ros López
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000175:diagnosis / Q000601:surgery*; D044583:Neuroendoscopy / Q000379:methods*; D012189:Retrospective Studies; D020542:Third Ventricle / Q000473:pathology / Q000601:surgery*; D014696:Ventriculostomy / Q000379:methods*