Hydrocephalus and Myelomeningocele

Abstract

HYDROCEPHALUS in early infancy is frequently fatal, and the risk of death may be increased in the presence of an associated myelomeningocele. An important cause of morbidity and mortality is infection, especially infection of the central nervous system. The exact pathogenesis of the infection is often difficult to delineate although it has frequently been associated with ruptured or granulating myelomeningoceles and with shunting procedures designed to alleviate the hydrocephalus. Several studies concerning central nervous system infection and hydrocephalus have included excellent case reports¹and large series^2,3which have emphasized the complexity and importance of the problem. Our recent experience with approximately 200 infants supports this emphasis and a review⁴of 50 infants with both myelomeningocele and hydrocephalus has specifically focused our attention on infection in these infants. The objectives of this paper are to summarize selected aspects of our recent experience with the problem and to propose