Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele.
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.
Hospital Martagão Gesteira, Salvador, BA, BR.
Jose Roberto Tude
JR
Melo
Hospital Martagão Gesteira, Salvador, BA, BR.
Pollyana
P
Pacheco
Hospital Martagão Gesteira, Salvador, BA, BR.
Emília Nunes de
EN
Melo
Hospital Martagão Gesteira, Salvador, BA, BR.
Ângela
Â
Vasconcellos
Hospital Martagão Gesteira, Salvador, BA, BR.
Rosane Klein
RK
Passos
D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt