The prediction of postoperative hydrocephalus in patients with spina bifida

Object The object was to derive a prediction rule for the development of postoperative hydrocephalus in patients with spina bifida by the measurement of cranial ventricular diameters using ultrasound.Methods Eighty-nine patients with spina bifida were studied prospectively. Each child had preoperative cranial ultrasound with measurement of the bifrontal diameter, bicaudate diameter and maximum transverse diameter of the body of the lateral ventricle by a single blinded observer. Repair of meningomyelocele was then undertaken and the patients followed up for development or progression of hydrocephalus. Logistic regression analysis determined the lowest values of the three cranial ventricular diameters associated with the maximum sensitivity and specificity for predicting postoperative hydrocephalus. These values were—bifrontal diameter >26 mm, bicaudate diameter >20 mm and body of lateral ventricle diameter >26 mm.Conclusions It is possible to predict the development of postoperative hydrocephalus in patients with spina bifida by measuring cranial ventricular dimensions using preoperative ultrasound.