Frequency of Hydrocephalus in Patients Presenting with Spinal Dysraphism

Authors

  • Muhammad Usman House No. 11-A, Aashian-e-Yousaf, Zaryab Colony, Faqirabad No. 2, Peshawar – Pakistan
  • HAYAT MOHAMMAD KHAN Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar – Pakistan
  • MUMTAZ ALI Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar – Pakistan
  • Raza Aman Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar – Pakistan
  • Naeem -ul-Haq Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar – Pakistan
  • Mohammad Ishaq Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar – Pakistan

Keywords:

Hydrocephalus, Spinal Dysraphism,, Spina Bifida, Lumbar region

Abstract

Objective: The objective of this study is to determine the frequency of hydrocephalus in patients presenting with spinal dysraphism.
Material and Methods: This cross sectional descriptive study was conducted at Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital, Peshawar, Pakistan. A total of 119 patients of spinal dysraphism were included through convenience (non-probability) sampling, in a period of six months (from June, 2011 to December 2011). All patients with spinal dysraphism with either sex and age less than 2 years included, while patients with post spinal dysraphism surgery who developed hydrocephalus, posterior fossa lesion causing obstructive hydrocephalus and Patients with post tuberculous meningitis with hydrocephalus were excluded. Hydrocephalus was observed in these patients. The data was analyzed using the statistical program SPSS version 17.
Results: Out of total number of 119 patients, majority was males with 66 in number (55.5%), while female were 53 (44.5%). The age of patients ranged from 10 days to 23 months with overall mean age 5.47 + 5.439 months. Majority of patients, 82 (68.9%), were in the age range of 01-06 months. Most of the patients, i.e., 56 (47.1%) were harboring spinal dysraphism at lumbar region. Hydrocephalus was found in quite large number of cases, 79 cases (66.4%), in patients of spinal dysraphism.
Conclusion: Spinal dysraphism is slightly more common in males with frequency of 55.5%. Majority of the patients of spinal dysraphism (68.9%) were presented in the age range of 1 – 6 months. Spinal dysraphism is more common (47.1%) at lumbar region. Hydrocephalus was found in 79 cases (66.4%) of spinal dysraphism.

References

1. Netto JMB, Bastos AN, Figueiredo AA, Pérez LM. Spi-nal dysraphism: A neurosurgical review for the urolo-gist. Rev Urol. 2009; 11 (2): 71-81.
2. Hashim SM, Ahmed S, Jooma R. management of mye-lomeningocele. J Surg Pak. 2008 March; 13 (1): 7-11.
3. Vinck A, Maassen B, Mullaart R, Rotteveel J. Arnold-Chiari-II malformation and cognitive functioning in spina bifida. J Neurol Neurosurg Psychiatry, 2006; 77: 1083–6.
4. Werhagen L, Hultling C, Borg K. Pain, especially neu-ropathic pain, in adults with Spina Bifida, and its relat-ion to age, neurological level, completeness, gender and Hydrocephalus. J Rehabil Med, 2010; 42: 374–6.
5. Higashida T, Sasano M, Sato H, Sekido K, Ito S: Mye-lomeningocele associated with split cord malformation type I. Neurol Med Chir (Tokyo). 2010; 50: 426-30.
6. Garne E, Loane M, Addor MC, Boyd PA, Barisi I, Dolk H. Congenital Hydrocephalus – prevalence, prenatal diagnosis and outcome of pregnancy in three European regions. European J Pediatr Neurol. 2010; 14 (2): 150-5.
7. Grogorean VT, Popescu M, Sandu AM, Toader S. Ven-triculoepiploic Shunt, a new surgical procedure for the treatment of Hydrocephalus. J Experimental Medical and Surgical Research, 2010; 1: 55-63.
8. Talamonti G, D’Aliberti G, Collice M: Myelomeningo-cele: long-term neurosurgical treatment and follow-up in 202 patients. J Neurosurg. 2007; 107 (5 Suppl): 368-86.
9. Albright AL Matson lecture: the past, present & future of pediatric neurosurgery. J Neurosurg. 2004; 101: 125-9.
10. Cohen AR. Myelomeningocele and Myelocystocele Pediatric Neurosurgery Robinson’s (ed) 4th Edition Ch. 203; 3215-27.
11. Logan WJ. Neurological examination in infancy and childhood chapter 200 sections VII. Pediatrics; 3169-86.
12. MC Neely PD, Howe WJ. In effectiveness of dietary folic acid supplementation on the incidence of lipomye-lomeningocele: pathogenic implications. J Neurosurg. 2004; 100: 98-100.
13. Zerah M, Roujeau T, Catala M. Spinal lipomas. In: Ozek, Cinalli, Maixner. (Eds.), Spina Bifida: Manage-ment and Outcome. Springer, New York, 2008: 445-74.
14. Venkataramana NK. Spinal dysraphism. J Pediatr Neu-rosci. 2011; 6: 31-40.
15. Bauer SB, Labib KB, Dieppa RA, Retik AB. Urodyna-mic evaluation of boy with myelodysplasia and inconti-nence. Urology, 1977; 10: 354-62.
16. van Leeuwen R, Notermans NC, Vandertop WP. Sur-gery in adults with tethered cord syndrome: outcome study with independent clinical review. J Neurosurg. 2001; 94 (2): 205–9.
17. Hudgins RJ, Gilreath CL. Tethered spinal cord follow-ing repair of myelomeningocele. Neurosurg Focus, 2004; 16 (2): E7.
18. Hüttmann S, Krauss J, Collmann H, Sörensen N, Roo-sen K. Surgical management of tethered spinal cord in adults: report of 54 cases. J Neurosurg. 2001; 95 (2): 173–8.
19. Lee GY, Paradiso G, Tator CH, Gentili F, Massicotte EM, Fehlings MG. Surgical management of tethered cord syndrome in adults: indications, techniques, and long-term outcomes in 60 patients. J Neurosurg Spine, 2006; 4: 123–31.
20. Rajpal S, Tubbs RS, George T, Oakes WJ, Fuchs HE, Hadley MN et al. Tethered cord due to spina bifida occulta presenting in adulthood: a tricenter review of 61 patients. J Neurosurg Spine, 2007; 6: 210–5.
21. Lorber J. Results of treatment of myelomeningocele. An analysis of 524 unselected cases, with special refe-rence to possible selection for treatment. Dev Med Chi-ld Neurol. 1971; 13: 279–303.
22. Idowu O, Olumide A. Etiology and cranial CT scan profile of nontumoral hydrocephalus in a tertiary black African hospital. J Neurosurg Pediatrics, 2011; 7: 397-
Frequency of Hydrocephalus in Patients Presenting with Spinal Dysraphism
Pak. J. of Neurol. Surg. – Vol. 18, No. 1, Jan. – Jun., 2014 -61-
400.
23. Kurtzke JF, Goldberg ID, Kurland LT. Congenital mal-formations of the nervous system. In: Kurland LT, Kur-tzke JF, Goldberg ID (eds.) Epidemiology of Neurolo-gic and Sense Organ Disorders. Harvard: Harvard Uni-versity Press; 1973: p 169-209.
24. MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council vitamin study. Lancet. 1991; 338: 131-7.
25. Folic acid and the prevention of neural tube defects. Report from an expert advisory group. Department of Health, 1992.

Downloads

Published

2014-06-30

Issue

Vol. 18 No. 1 (2014): January-June

Section

Original Articles

License

The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).