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Systematic Ventriculographic Studies in Infants Born with Meningomyelocele and Encephalocele: The Incidence and Development of Hydrocephalus

1961; BMJ; Volume: 36; Issue: 188 Linguagem: Inglês

10.1136/adc.36.188.381

1468-2044

J. Lorber,

Spinal Dysraphism and Malformations

Increasing experience and the introduction of new techniques in the treatment of congenital hydrocephalus demand its earliest possible recognition and knowledge of its natural history.By far the commonest type of congenital hydrocephalus is the one associated with a meningomyelocele or encephalocele.The presence of hydrocephalus in such infants should be suspected at birth, simply because the association is so common. Present InvestigationAn investigation was started on January 1, 1959, in the Children's Hospital, Sheffield.Its first purpose was to determine the incidence and degree of hydrocephalus in infants who were born with meningomyelocele or encephalocele, and to relate this incidence to various clinical features.The second purpose was to determine what effect, if any, early operation on the meningomyelocele would have on the development of hydrocephalus, and to determine the prognosis for those who had no hydrocephalus at the first examination.Its third purpose was to include those infants, who were found to have a hydrocephalus, in a controlled therapeutic trial.This paper deals with the results of the first two aspects of the investigations. MethodsInfants with meningomyelocele or encephalocele were subjected to full clinical examination.The main method of investigation was ventriculography, which was often associated with dye penetration studies and sometimes with pneumoencephalography.The term 'hydrocephalus' in this paper refers to the radiological diagnosis of a pathologically distended ventricular system on ventriculo- graphy irrespective of any other feature.Ventriculo-