article
Neurogenic bladder dysfunction as signal of late failure of endoscopic third ventriculostomy in child with spina bifida
Registro en:
10.1016/j.wneu.2019.05.138
Autor
Silva Neto, Angelo R.
Uruguay, Ana Luíza R.
Paiva, Damácio S.
Silva, Alice L.P.
Godeiro, Arthur H.M
Eberlin, Letícia M.N.
Resumen
BACKGROUND: Endoscopic third ventriculostomy (ETV) is an option for hy-drocephalus treatment in patients with myelomeningocele, mostly after a previous shunt dysfunction. Late failure of ETV is a rare event, traditionally associated with dramatic symptoms of intracranial hypertension. In patients with myelodysplasia and neurogenic bladder dysfunction, urodynamic deterioration can be a signal of neurologic worsening as a consequence of tethered cord or shunt problems.
- CASE DESCRIPTION: We describe here a rare case of a 12-year-old female patient with myelomeningocele and evidence of a failure 10 years after a previously successful ETV whose initial symptoms were worsening of urinary complaints. After 2 months, she was admitted to the emergency department with
seizures and acute hydrocephalus and was shunted.
- CONCLUSIONS: Pediatric neurosurgeons must follow myelomeningocele patients with successful ETV for a long time and take care of subtle alterations of organic functions that have a close relationship with central nervous system integrity. A multidisciplinary approach can facilitate this strategy and avoid a tragic outcome.