[Evaluation of shunt treatment in hydrocephalus with myelomeningocele: some factors relating to mental prognosis].

From 1971 to 1986, the authors experienced 64 patients of myelomeningocele. Sixty out of 64 cases (94%) had both myelomeningocele and hydrocephalus. A retrospective analysis about these hydrocephalic patients was conducted on various factors relating to intelligence. Forty-nine cases received cerebrospinal fluid diversion operation within 2 years of life, while 6 cases had ventriculo-peritoneal shunt after 7 years of age and 5 cases had no surgical treatment for hydrocephalus. Statistically the following factors were significantly related to low intelligence: 1) ventriculitis suffered within two months of life: 2) association of symptomatic Arnold-Chiari malformation, and 3) myelodysplasia at or above the L2 level. However, there was no statistically significant relationship between mental prognosis and age at initial shunt, degree of ventricular dilatation before and after shunt, numbers of shunt revision, epilepsy, or subdural hematoma after shunt. These findings suggest that hydrocephalic patients with myelomeningocele will be expected to have better mental prognosis if the hydrocephalus is well controlled by shunting and if they do not have other severe malformations of the central nervous system.