The Casey Holter lecture. Non-selective intervention in newborn babies with open spina bifida: the outcome 30 years on for the complete cohort.

The disability in neural tube defect is determined by the neurological deficit. The sensory level is a reliable measure of this deficit and predicts the disability. Achievement at the age of 30 related as well as to IQ and disability events in the history of CSF shunt. Episodes of raised intracranial pressure may damage the brain and visual pathways. They may also reduce achievement and enterprise. Blockage of the CSF shunt, when symptomatic, should be treated urgently, especially when it occurs after infancy. Blockage of the CSF shunt when asymptomatic was not usually associated with a low IQ or poor achievement.