INCIDENCE OF HYDROCEPHALUS IN POST-OPERATIVE OF MENINGOMYELOCELE REPAIR
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Keywords
Hydrocephalus, Meningomyelocele, Post-operative complications, Shunting, Chiari malformation, Cerebrospinal fluid, Neonatal surgery.
Abstract
Introduction: Meningomyelocele (MMC) is a congenital malformation where the spinal cord and its protective membranes protrude through a defect in the vertebral column. This condition is a form of spina bifida and is one of the most common neural tube defects in neonates. Although surgery to repair the defect is typically performed soon after birth, the development of hydrocephalus remains one of the most significant complications. Objective: To evaluate the incidence of hydrocephalus in patients following meningomyelocele repair and identify the associated risk factors such as lesion level, Chiari malformation, and head circumference at birth. Methodology: This prospective observational study analyzed 150 patients who underwent meningomyelocele repair. Data were collected on the development of hydrocephalus, including preoperative head circumference, lesion level, presence of Chiari malformation, and the timing of hydrocephalus onset. Imaging studies (CT/MRI) were used to confirm hydrocephalus, and shunting procedures were documented when necessary. Results: The study found that 40% of patients developed hydrocephalus post-operatively, with a higher incidence observed in patients with higher lesion levels and those with Chiari malformation. Additionally, patients with larger head circumferences at birth were more likely to develop hydrocephalus. Conclusion: Hydrocephalus remains a significant post-operative complication following meningomyelocele repair, with the incidence influenced by factors such as lesion level, Chiari malformation, and head circumference. Early detection and timely management, including shunting, are critical for improving long-term outcomes in these patients.
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Dr Naveed Ahmed
Neurosurgical Resident, PIMS, Islamabad.
Dr Lal Rehman
Professor, Head of Department, Neurosurgery, PIMS, Islamabad
Dr Faizullah Khan
Senior registrar, Neurosurgery department PIMS, Islamabad
Dr Ali Raza
Neurosurgical Resident, PIMS, Islamabad
Dr Naveed Khan
Neurosurgical Resident, PIMS, Islamabad
Dr Sidra tul Muntaha
House officer, PIMS, Islamabad