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Child's Nervous System

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01-07-2018 | Original Paper

Experience in shunt management on revision free survival in infants with myelomeningocele

Authors: Sara Al-Hakim, Andreas Schaumann, Joanna Schneider, Matthias Schulz, Ulrich-Wilhelm Thomale

Published in: Child's Nervous System | Issue 7/2018

Abstract

Objective

Depending on the etiology of hydrocephalus in childhood, the shunt therapy still remains challenging due to frequent shunt complications leading to possible revisions such as shunt infection or shunt malfunction. In myelomeningocele (MMC) patients who often require shunt therapy, higher revisions rates were reported. In a single-center retrospective study, experiences on shunt regimen on hydrocephalus associated with MMC are presented.

Methods

Data of 160 infant hydrocephalus cases younger than 1 year of age at the time of implantation were retrospectively reviewed from the hospital database. These patients received an adjustable differential pressure valve with gravitational unit and antibiotic impregnated catheters as a primary or secondary implant during the time period of April 2007 to July 2015. The subgroup of infants cases with MMC (n = 44; age 50.6 ± 80.6 days) were compared to the remaining cohort of other hydrocephalus etiology (control group). The shunt and valve revision free survival rates were recorded until July 2017.

Results

During the mean follow-up of 48.7 ± 19.2 (7–114) months, the shunt revision free survival was 87% at 1 year and 49% at 60 months in the MMC cohort. The control group showed a shunt survival rate of 68% at 1 year and 39% at 60 months. Similarly, the valve revision free survival rate showed a significant higher rate of 92% at 1 year and 69% at 60 months in the MMC group compared to the control group (75% at 1 year and 51% at 60 months; p < 0.05). During the entire follow-up period, 37% of the MMC infants underwent a revision operation in contrast to the control group of 40%.

Conclusion

The presented shunt strategy showed improved revision free survival rates in infants with a MMC-related hydrocephalus in comparison to other etiologies of hydrocephalus in infants, which might relate to infection prophylaxis and high drainage resistance integrated in the shunt system.

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Title: Experience in shunt management on revision free survival in infants with myelomeningocele
Authors: Sara Al-Hakim
Andreas Schaumann
Joanna Schneider
Matthias Schulz
Ulrich-Wilhelm Thomale
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 7/2018
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-018-3781-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Experience in shunt management on revision free survival in infants with myelomeningocele

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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