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Chapter 35 - Myelomeningocele and Hydrocephalus

Published online by Cambridge University Press:  30 November 2019

By
Adam C. Adler
Edited by
Adam C. Adler ,
Arvind Chandrakantan  and
Ronald S. Litman
Adam C. Adler
Affiliation:
Texas Children's Hospital
Arvind Chandrakantan
Affiliation:
Texas Children's Hospital
Ronald S. Litman
Affiliation:
The Children's Hospital of Philadelphia
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Summary

In this chapter, the common pediatric conditions of Myelomeningocele and Hydrocephalus are reviewed. The pathophysiology of spina bifida is discussed in relation of both post-natal and fetal surgical management. The author covers the surgical interventions and the related complex anesthetic considerations for both the primary repair of myelomeningocele as well as for ventriculoperitoneal shunt placement. The presentation of patients with raised intracranial pressure in the setting of hydrocephalus is considered.

Keywords

spina bifidaMyelomeningoceleHydrocephalusfolate deficiencyChiari malformationscerebrospinal fluidfetal repairlatex allergyevoked potentialsintracranial pressureICPCushing reflexCushing triadventriculoperitoneal shunt.
Type
Chapter
Information
Case Studies in Pediatric Anesthesia , pp. 152 - 156
Publisher: Cambridge University Press
Print publication year: 2019

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References

Suggested Reading

Adzick, NS. Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med. 2010;15(1):9–14. PMID: 19540177.CrossRefGoogle ScholarPubMed
Adzick, NS. Fetal surgery for spina bifida: past, present, future. Semin Pediatr Surg. 2013;22(1):10–17. PMID: 23395140.CrossRefGoogle ScholarPubMed
Hadley, DM. The Chiari malformations. J Neurol Neurosurg Psychiatry. 2002;72 Suppl 2:ii38–ii40. PMID: 12122202.Google ScholarPubMed
Kumar, A, Bhattacharya, A, Makhija, N. Evoked potential monitoring in anaesthesia and analgesia. Anaesthesia. 2000;55(3):225–41. PMID: 10671840.CrossRefGoogle ScholarPubMed
Mitchell, LE, Adzick, NS, Melchionne, J, et al. Spina bifida. Lancet. 2004;364(9448):1885–95. PMID: 15555669.CrossRefGoogle ScholarPubMed

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