Neurogenic bladder dysfunction as signal of late failure of endoscopic third ventriculostomy in child with spina bifida

• Autor(a) principal: Silva Neto, Angelo R.
• Data de Publicação: 2019
• Outros Autores: Uruguay, Ana Luíza R., Paiva, Damácio S., Silva, Alice L.P., Godeiro, Arthur H.M, Eberlin, Letícia M.N.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRN
• Texto Completo: https://repositorio.ufrn.br/handle/123456789/52365
• topic: long-term outcome; neurogenic bladder; pediatric hydrocephalus; third ventriculostomy

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.