{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:25:55Z","timestamp":1791419155479,"version":"4.3.3"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Hydrocephalus is the most important co-morbidity in myelomeningocele from a neurosurgical perspective. Historically, 75-80% of patients with myelomeningocele have required treatment with a shunt but recent advances including intra-uterine myelomeningocele closure and ETV-CPC are reducing this burden. The expression of hydrocephalus differs between patients and across the life span. Hydrocephalus impacts the clinical expression of other important co-morbidities including the Chiari II malformation and tethered spinal cord. Shunt failure is often the key stress to prompt symptomatic worsening of these other conditions. Shunt failure may occur with minimal ventricular change on CT or MRI in Spina Bifida patients. Waiting for radiographic changes in symptomatic SB patients with shunts may result in hydrocephalus related fatalities. It is hypothesized but not proven that shunt failure may contribute to respiratory insufficiency and be a risk factor for sudden death in adult patients with spina bifida. Excellence in hydrocephalus management in MMC is essential for proper care, good outcomes, and quality of life for patients and families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0028-3886.332247","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:37:09Z","timestamp":1640655429000},"page":"S367-S371","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":37,"title":["Hydrocephalus in Spina Bifida"],"prefix":"10.4103","volume":"69","author":[{"given":"Jeffrey P","family":"Blount","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedram","family":"Maleknia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy D","family":"Hopson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon G","family":"Rocque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W J","family":"Oakes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20240907","doi-asserted-by":"crossref","first-page":"15007","DOI":"10.1038\/nrdp.2015.7","article-title":"Spina bifida","volume":"1","author":"Copp","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"R2-18-20240907","doi-asserted-by":"crossref","first-page":"213","DOI":"10.7196\/SAMJ.8079","article-title":"Spina bifida: A multidisciplinary perspective on a many-faceted condition","volume":"104","author":"Fieggen","year":"2014","journal-title":"S Afr Med J"},{"key":"R3-18-20240907","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1017\/S1355617719001176","article-title":"Long-term intellectual and fine motor outcomes in spina bifida are related to myelomeningocele repair and shunt intervention history","volume":"26","author":"Ware","year":"2020","journal-title":"J Int Neuropsychol Soc"},{"key":"R4-18-20240907","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/2019.7.FOCUS19469","article-title":"Myelomeningocele-associated hydrocephalus: Nationwide analysis and systematic review","volume":"47","author":"McCarthy","year":"2019","journal-title":"Neurosurg Focus"},{"key":"R5-18-20240907","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1014379","article-title":"A randomized trial of prenatal versus postnatal repair of myelomeningocele","volume":"364","author":"Adzick","year":"2011","journal-title":"N Engl J Med"},{"key":"R6-18-20240907","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3171\/2019.4.PEDS18383","article-title":"Fetal surgery for spina bifida","volume":"24","author":"Dewan","year":"2019","journal-title":"J Neurosurg Pediatr"},{"key":"R7-18-20240907","doi-asserted-by":"crossref","first-page":"E8","DOI":"10.3171\/2019.7.FOCUS19406","article-title":"Pediatric neurosurgeons' views regarding prenatal surgery for myelomeningocele and the management of hydrocephalus: A national survey","volume":"47","author":"Riley","year":"2019","journal-title":"Neurosurg Focus"},{"key":"R8-18-20240907","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1093\/neuros\/nyz302","article-title":"Detailed analysis of hydrocephalus and hindbrain herniation after prenatal and postnatal myelomeningocele closure: Report from a single institution","volume":"86","author":"Flanders","year":"2020","journal-title":"Neurosurgery"},{"key":"R9-18-20240907","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1053\/j.sempedsurg.2012.10.003","article-title":"Fetal surgery for spina bifida: Past, present, future","volume":"22","author":"Adzick","year":"2013","journal-title":"Semin Pediatr Surg"},{"key":"R10-18-20240907","doi-asserted-by":"crossref","first-page":"E405","DOI":"10.1093\/neuros\/nyz262","article-title":"Congress of neurological surgeons systematic review and evidence-based guideline on the incidence of shunt-dependent hydrocephalus in infants with myelomeningocele after prenatal versus postnatal repair","volume":"85","author":"Tamber","year":"2019","journal-title":"Neurosurgery"},{"key":"R11-18-20240907","doi-asserted-by":"crossref","first-page":"646","DOI":"10.3171\/2018.5.PEDS18161","article-title":"Treated hydrocephalus in individuals with myelomeningocele in the National spina bifida patient registry","volume":"22","author":"Kim","year":"2018","journal-title":"J Neurosurg Pediatr"},{"key":"R12-18-20240907","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1007\/s00381-021-05089-9","article-title":"Neuropsychological profiles in children and young adults with spina bifida","volume":"37","author":"Rendeli","year":"2021","journal-title":"Childs Nerv Syst"},{"key":"R13-18-20240907","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1159\/000513311","article-title":"Open fetal microneurosurgery for intrauterine spina bifida repair","volume":"48","author":"Cruz-Martinez","year":"2021","journal-title":"Fetal Diagn Ther"},{"key":"R14-18-20240907","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s00381-017-3428-8","article-title":"First 60 fetal in-utero myelomeningocele repairs at Saint Louis fetal care institute in the post-MOMS trial era: Hydrocephalus treatment outcomes (endoscopic third ventriculostomy versus ventriculo-peritoneal shunt)","volume":"33","author":"Elbabaa","year":"2017","journal-title":"Childs Nerv Syst"},{"key":"R15-18-20240907","first-page":"112","article-title":"Fetal surgery: The ochsner experience with in utero spina bifida repair","volume":"14","author":"Kahn","year":"2014","journal-title":"Ochsner J"},{"key":"R16-18-20240907","doi-asserted-by":"crossref","first-page":"495.e1","DOI":"10.1016\/j.ajog.2016.05.028","article-title":"The impact of mode of delivery on infant neurologic outcomes in myelomeningocele","volume":"215","author":"Greene","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"R17-18-20240907","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/BF00304828","article-title":"The effects of labor and delivery on spinal cord function and ambulation in patients with meningomyelocele","volume":"7","author":"Cochrane","year":"1991","journal-title":"Childs Nerv Syst"},{"key":"R18-18-20240907","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ejogrb.2011.01.012","article-title":"Influence of birth mode on early neurological outcome in infants with myelomeningocele","volume":"156","author":"Cuppen","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R19-18-20240907","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.pcl.2021.04.013","article-title":"Caring for the child with spina bifida","volume":"68","author":"Rocque","year":"2021","journal-title":"Pediatr Clin North Am"},{"key":"R20-18-20240907","first-page":"467","article-title":"Neurosurgery guidelines for the care of people with spina bifida","volume":"13","author":"Blount","year":"2020","journal-title":"J Pediatr Rehabil Med"},{"key":"R21-18-20240907","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1310\/sci2204-241","article-title":"Current management strategies of hydrocephalus in the child with open spina bifida","volume":"22","author":"Norkett","year":"2016","journal-title":"Top Spinal Cord Inj Rehabil"},{"key":"R22-18-20240907","first-page":"10","article-title":"Care management and contemporary challenges in spina bifida: A practice preference survey of the American society of pediatric neurosurgeons","volume":"1","author":"Alford","year":"2019","journal-title":"J Neurosurg Pediatr"},{"key":"R23-18-20240907","first-page":"194","article-title":"Timing of shunt insertion in children with neural tube defects and hydrocephalus: A clinical study","volume":"30","author":"Ozgural","year":"2020","journal-title":"Turk Neurosurg"},{"key":"R24-18-20240907","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00381-010-1082-5","article-title":"Hydrocephalus shunt practice of experienced pediatric neurosurgeons","volume":"26","author":"Albright","year":"2010","journal-title":"Childs Nrv Syst"},{"key":"R25-18-20240907","first-page":"94","article-title":"The association between the timing of shunt placement and shunt infection in hydrocephalus associated with myelomeningocele","volume":"30","author":"Gurbuz","year":"2020","journal-title":"Turk Neurosurg"},{"key":"R26-18-20240907","doi-asserted-by":"crossref","first-page":"361","DOI":"10.3171\/PED\/2008\/1\/5\/361","article-title":"Toward reducing shunt placement rates in patients with myelomeningocele","volume":"1","author":"Chakraborty","year":"2008","journal-title":"J Neurosurg Pediatr"},{"key":"R27-18-20240907","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1159\/000485251","article-title":"The use of external ventricular drainage to reduce the frequency of wound complications in myelomeningocele closure","volume":"53","author":"McDowell","year":"2018","journal-title":"Pediatr Neurosurg"},{"key":"R29-18-20240907","first-page":"8","article-title":"Comparison of endoscopic third ventriculostomy with or without choroid plexus cauterization in pediatric hydrocephalus: A systematic review and meta-analysis","volume":"1","author":"Ellenbogen","year":"2020","journal-title":"J Neurosurg Pediatr"},{"key":"R30-18-20240907","doi-asserted-by":"crossref","first-page":"310","DOI":"10.3171\/PED.2008.2.11.310","article-title":"Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: Long-term results of a prospective intent-to-treat study in 115 East African infants","volume":"2","author":"Warf","year":"2008","journal-title":"J Neurosurg Pediatr"},{"key":"R31-18-20240907","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3171\/2019.3.PEDS18532","article-title":"Predictors of success for combined endoscopic third ventriculostomy and choroid plexus cauterization in a North American setting: A hydrocephalus clinical research network study","volume":"24","author":"Riva-Cambrin","year":"2019","journal-title":"J Neurosurg Pediatr"},{"key":"R32-18-20240907","doi-asserted-by":"crossref","first-page":"295","DOI":"10.3171\/2013.11.PEDS13138","article-title":"The comparative effectiveness of ventricular shunt placement versus endoscopic third ventriculostomy for initial treatment of hydrocephalus in infants","volume":"13","author":"Jernigan","year":"2014","journal-title":"J Neurosurg Pediatr"},{"key":"R33-18-20240907","doi-asserted-by":"crossref","first-page":"564","DOI":"10.3171\/2009.7.PEDS09136","article-title":"Neurocognitive outcome and ventricular volume in children with myelomeningocele treated for hydrocephalus in Uganda","volume":"4","author":"Warf","year":"2009","journal-title":"J Neurosurg Pediatr"},{"key":"R34-18-20240907","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jocn.2020.10.047","article-title":"Analysis of shunted hydrocephalus follow-up: What do routine clinic visits yield? What factors affect revision surgery presentation and outcomes?","volume":"82","author":"Rubino","year":"2020","journal-title":"J Clin Neurosci"},{"key":"R35-18-20240907","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1097\/DBP.0b013e31828c5f88","article-title":"Spina bifida grown up","volume":"34","author":"Liptak","year":"2013","journal-title":"J Dev Behav Pediatr"},{"key":"R36-18-20240907","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/PHM.0000000000000964","article-title":"Co-morbidities associated with early mortality in adults with spina bifida","volume":"97","author":"Dicianno","year":"2018","journal-title":"Am J Phys Med Rehabil"},{"key":"R37-18-20240907","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1080\/09638288.2019.1621953","article-title":"50 years and older-born with spina bifida: Participation, health issues and physical function","volume":"43","author":"Lidal","year":"2021","journal-title":"Disabil Rehabil"},{"key":"R38-18-20240907","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/ddrr.99","article-title":"Optimizing health care for adults with spina bifida","volume":"16","author":"Webb","year":"2010","journal-title":"Dev Disabil Res Rev"},{"key":"R39-18-20240907","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2016.8.FOCUS16257","article-title":"Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele","volume":"41","author":"Dupepe","year":"2016","journal-title":"Neurosurg Focus"},{"key":"R40-18-20240907","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/dmcn.12952","article-title":"Life course health and healthcare utilization among adults with spina bifida","volume":"58","author":"Liptak","year":"2016","journal-title":"Dev Med Child Neurol"},{"key":"R41-18-20240907","doi-asserted-by":"crossref","first-page":"e01736","DOI":"10.1002\/brb3.1736","article-title":"Adults with spina bifida: A cross-sectional study of health issues and living conditions","volume":"10","author":"Bendt","year":"2020","journal-title":"Brain Behav"},{"key":"R42-18-20240907","first-page":"23","article-title":"A new clinic for young adults with spina bifida and\/or hydrocephalus--age 16-25 years","volume":"3","author":"Morgan","year":"1993","journal-title":"Eur J Pediatr Surg"},{"key":"R43-18-20240907","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.wneu.2019.05.138","article-title":"Neurogenic bladder dysfunction as signal of late failure of endoscopic third ventriculostomy in child with spina bifida","volume":"128","author":"Silva Neto","year":"2019","journal-title":"World Neurosurg"}],"container-title":["Neurology India"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.332247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:52:18Z","timestamp":1787755938000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0028-3886.332247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":42,"journal-issue":{"issue":"Suppl 2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/0028-3886.332247","relation":{},"ISSN":["0028-3886"],"issn-type":[{"value":"0028-3886","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}