MANAGEMENT AND OUTCOMES OF MYELOMENINGOCELE ASSOCIATED HYDROCEPHALUS
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Abstract
Introduction: Hydrocephalus, which is a clinical phenomenon with poor circulation in cerebrospinal fluids, is often related to myelomeningocele because of the disruptions.
Objectives: The main objective of the study is to find the management and outcomes of myelomeningocele associated hydrocephalus.
Methodology of the study: This retrospective design study was conducted at Lady Reading Hospital, Peshawar from January 2021 to December 2023. Data were collected from 80 patients suffering from myelomeningocele associated hydrocephalus. Data were extracted from electronic medical records and imaging databases, encompassing demographic information, prenatal history, myelomeningocele characteristics, associated anomalies, initial presentation, diagnostic findings, treatment modalities, perioperative complications, and long-term outcomes. Data were collected through a designed performa.
Results: Data were collected from 80 patients according to inclusion criteria of the study. Mean age was 6 ± 2.5 months and out of 80 patients there were 55 male and 45 female patients. 60% shows lumbar myelomeningocele, 25% thoracic and 15% shows lumbosacral myelomeningocele. 40% patients show the prenatal history of associated anomalies.In our study, the most common treatment modality for myelomeningocele-associated hydrocephalus was ventriculoperitoneal shunt placement (VPS), utilized in 65% of cases. Endoscopic third ventriculostomy (ETV) was employed in 20% of patients, providing an alternative to shunt placement. Shunt revisions were required in 15% of cases, highlighting the challenges associated with long-term shunt management.
Conclusion: It is concluded that the management of myelomeningocele-associated hydrocephalus requires a multidisciplinary approach tailored to individual patient needs. Despite challenges such as perioperative complications, our study demonstrates promising long-term outcomes, emphasizing the efficacy of current treatment strategies.
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Syed Mansoor Shah
Resident Neurosurgeon, Neurosurgery Department, Lady Reading Hospital, Peshawar
Aafaq Ahmad Qarnain Khalil
Resident Neurosurgeon, Neurosurgery Department, Prime Teaching Hospital, Peshawar
Dr Fakhar Hayat
Consultant Neurosurgeon, Neurosurgery Department, King Hamad University Hospital, Manama
Muhammad Assad Javed
Assistant Professor, Neurosurgery Department, Akbar Niazi Teaching Hospital/ IMDC, Islamabad
Rizwan Khan
Post Doctoral Researcher, Eye Institute of Xiamen University and Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen 361000, China
Faizuddin
Assisstant Professor, Department of Neurosurgery, Shaikh Khalifa Bin Zeyyad Hospital Quetta
Mian Iftikhar ul Haq
Assistant Professor, Neurosurgery Unit, Hayathabad Medical Complex Hospital Peshawar