Neurogenic Bladder Dysfunction as Signal of Late Failure of Endoscopic Third Ventriculostomy in Child with Spina Bifida

Endoscopic third ventriculostomy (ETV) is an option for hydrocephalus treatment in patients with myelomeningocele, mostly after a previous shunt dysfunction. Late failure of ETV is a rare event, traditionally associated with dramatic symptoms of intracranial hypertension. In patients with myelodyspl...

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Bibliographic Details
Published in:	World neurosurgery Vol. 128; pp. 454 - 457
Main Authors:	Silva Neto, Angelo R., Uruguay, Ana Luíza R., Paiva, Damácio S., Silva, Alice L.P., Godeiro, Arthur H.M., Eberlin, Letícia M.N.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-08-2019
Subjects:	Child Female Humans Hydrocephalus - complications Hydrocephalus - surgery Long-term outcome Meningomyelocele - complications Meningomyelocele - surgery Neuroendoscopy Neurogenic bladder Pediatric hydrocephalus Spinal Dysraphism - complications Spinal Dysraphism - surgery Third Ventricle - surgery Third ventriculostomy Treatment Failure Urinary Bladder, Neurogenic - etiology Ventriculoperitoneal Shunt Ventriculostomy Pediatric hydrocephalus Third ventriculostomy Long-term outcome MR ETV Neurogenic bladder
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Summary:	Endoscopic third ventriculostomy (ETV) is an option for hydrocephalus treatment in patients with myelomeningocele, mostly after a previous shunt dysfunction. Late failure of ETV is a rare event, traditionally associated with dramatic symptoms of intracranial hypertension. In patients with myelodysplasia and neurogenic bladder dysfunction, urodynamic deterioration can be a signal of neurologic worsening as a consequence of tethered cord or shunt problems. We describe here a rare case of a 12-year-old female patient with myelomeningocele and evidence of a failure 10 years after a previously successful ETV whose initial symptoms were worsening of urinary complaints. After 2 months, she was admitted to the emergency department with seizures and acute hydrocephalus and was shunted. Pediatric neurosurgeons must follow myelomeningocele patients with successful ETV for a long time and take care of subtle alterations of organic functions that have a close relationship with central nervous system integrity. A multidisciplinary approach can facilitate this strategy and avoid a tragic outcome.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1878-8750 1878-8769
DOI:	10.1016/j.wneu.2019.05.138