Complications Associated with Myelomeningocele

Neurological Complications

• The American Academy of Neurology notes that hydrocephalus is the most frequent comorbidity in patients with myelomeningocele, requiring constant neurosurgical surveillance after defect repair 3, 4
• Prenatal repair of myelomeningocele significantly reduces the risk of developing shunt-dependent hydrocephalus compared to postnatal repair, with evidence classified as Class I 1, 2, 3, 4, 5
• The mortality rate for newborns with myelomeningocele is approximately 10%, with survivors facing significant morbidity requiring lifelong effort from multiple disciplines 3, 4, 5

Neurocognitive Complications

• The evidence on the impact of ventricular size on neurocognitive development is insufficient, with conflicting studies classified as Class III 6, 7
• Children with asymptomatic ventriculomegaly can be managed conservatively without surgery, monitoring for progressive macrocephaly and neurological signs 8
• Endoscopic third ventriculostomy (ETV) with or without choroid plexus coagulation frequently results in persistent ventriculomegaly, but neurocognitive outcomes are similar to those with ventriculoperitoneal shunting 8