Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele

Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development

Jeffrey P. Blount, Susan R. Durham, Paul Klimo, Nadege Assassi, David F. Bauer, Alexandra D. Beier, Ann Marie Flannery, Catherine McClung-Smith, Dimitrios C. Nikas, Patricia Rehring, Mandeep S. Tamber, Rachana Tyagi, Catherine A. Mazzola

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Myelomeningocele (MM) is the most common congenital anomaly to affect the nervous system and affects 1500-2000 newborn infants per year in the United States. It is accompanied by symptomatic hydrocephalus in approximately 70%-80% of patients. Different treatment strategies for hydrocephalus characteristically result in different effects on the size of the ventricles. OBJECTIVE: The objective of this systematic review was to determine whether persistent ventricular enlargement adversely impacts neurocognitive development in patients with MM. METHODS: The PubMed National Library of Medicine Medline database and Embase were queried using MeSH headings and keywords relevant to neurocognitive or intellectual development and ventricular size or morphology. Abstracts were reviewed by the authors to identify which studies met strict inclusion criteria. An evidence table was constructed that summarized the included studies and reflected the quality of evidence (Classes I-III) that each represented. A recommendation was made that is based on the quality of the evidence. RESULTS: An initial abstract review utilizing strict inclusion/exclusion criteria yielded 48 studies, 9 of which underwent full-Text review. There is limited and conflicting Class III evidence from 2 studies. CONCLUSION: Currently, there is insufficient data to conclude that ventricular size and morphology impact neurocognitive development. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-5.

Original languageEnglish (US)
Article numbernyz265
Pages (from-to)E414-E416
JournalClinical Neurosurgery
Volume85
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Meningomyelocele
Hydrocephalus
Cognition
Guidelines
Medical Subject Headings
National Library of Medicine (U.S.)
Spinal Dysraphism
PubMed
Nervous System
Newborn Infant
Databases
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele : Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development. / Blount, Jeffrey P.; Durham, Susan R.; Klimo, Paul; Assassi, Nadege; Bauer, David F.; Beier, Alexandra D.; Flannery, Ann Marie; McClung-Smith, Catherine; Nikas, Dimitrios C.; Rehring, Patricia; Tamber, Mandeep S.; Tyagi, Rachana; Mazzola, Catherine A.

In: Clinical Neurosurgery, Vol. 85, No. 3, nyz265, 01.09.2019, p. E414-E416.

Research output: Contribution to journalArticle

Blount, JP, Durham, SR, Klimo, P, Assassi, N, Bauer, DF, Beier, AD, Flannery, AM, McClung-Smith, C, Nikas, DC, Rehring, P, Tamber, MS, Tyagi, R & Mazzola, CA 2019, 'Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele: Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development', Clinical Neurosurgery, vol. 85, no. 3, nyz265, pp. E414-E416. https://doi.org/10.1093/neuros/nyz265
Blount, Jeffrey P. ; Durham, Susan R. ; Klimo, Paul ; Assassi, Nadege ; Bauer, David F. ; Beier, Alexandra D. ; Flannery, Ann Marie ; McClung-Smith, Catherine ; Nikas, Dimitrios C. ; Rehring, Patricia ; Tamber, Mandeep S. ; Tyagi, Rachana ; Mazzola, Catherine A. / Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele : Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development. In: Clinical Neurosurgery. 2019 ; Vol. 85, No. 3. pp. E414-E416.
@article{0d5f0f8dc10741cf882d2bfd791f3969,
title = "Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele: Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development",
abstract = "BACKGROUND: Myelomeningocele (MM) is the most common congenital anomaly to affect the nervous system and affects 1500-2000 newborn infants per year in the United States. It is accompanied by symptomatic hydrocephalus in approximately 70{\%}-80{\%} of patients. Different treatment strategies for hydrocephalus characteristically result in different effects on the size of the ventricles. OBJECTIVE: The objective of this systematic review was to determine whether persistent ventricular enlargement adversely impacts neurocognitive development in patients with MM. METHODS: The PubMed National Library of Medicine Medline database and Embase were queried using MeSH headings and keywords relevant to neurocognitive or intellectual development and ventricular size or morphology. Abstracts were reviewed by the authors to identify which studies met strict inclusion criteria. An evidence table was constructed that summarized the included studies and reflected the quality of evidence (Classes I-III) that each represented. A recommendation was made that is based on the quality of the evidence. RESULTS: An initial abstract review utilizing strict inclusion/exclusion criteria yielded 48 studies, 9 of which underwent full-Text review. There is limited and conflicting Class III evidence from 2 studies. CONCLUSION: Currently, there is insufficient data to conclude that ventricular size and morphology impact neurocognitive development. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-5.",
author = "Blount, {Jeffrey P.} and Durham, {Susan R.} and Paul Klimo and Nadege Assassi and Bauer, {David F.} and Beier, {Alexandra D.} and Flannery, {Ann Marie} and Catherine McClung-Smith and Nikas, {Dimitrios C.} and Patricia Rehring and Tamber, {Mandeep S.} and Rachana Tyagi and Mazzola, {Catherine A.}",
year = "2019",
month = "9",
day = "1",
doi = "10.1093/neuros/nyz265",
language = "English (US)",
volume = "85",
pages = "E414--E416",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Management of Patients with Myelomeningocele

T2 - Whether Persistent Ventriculomegaly Adversely Impacts Neurocognitive Development

AU - Blount, Jeffrey P.

AU - Durham, Susan R.

AU - Klimo, Paul

AU - Assassi, Nadege

AU - Bauer, David F.

AU - Beier, Alexandra D.

AU - Flannery, Ann Marie

AU - McClung-Smith, Catherine

AU - Nikas, Dimitrios C.

AU - Rehring, Patricia

AU - Tamber, Mandeep S.

AU - Tyagi, Rachana

AU - Mazzola, Catherine A.

PY - 2019/9/1

Y1 - 2019/9/1

N2 - BACKGROUND: Myelomeningocele (MM) is the most common congenital anomaly to affect the nervous system and affects 1500-2000 newborn infants per year in the United States. It is accompanied by symptomatic hydrocephalus in approximately 70%-80% of patients. Different treatment strategies for hydrocephalus characteristically result in different effects on the size of the ventricles. OBJECTIVE: The objective of this systematic review was to determine whether persistent ventricular enlargement adversely impacts neurocognitive development in patients with MM. METHODS: The PubMed National Library of Medicine Medline database and Embase were queried using MeSH headings and keywords relevant to neurocognitive or intellectual development and ventricular size or morphology. Abstracts were reviewed by the authors to identify which studies met strict inclusion criteria. An evidence table was constructed that summarized the included studies and reflected the quality of evidence (Classes I-III) that each represented. A recommendation was made that is based on the quality of the evidence. RESULTS: An initial abstract review utilizing strict inclusion/exclusion criteria yielded 48 studies, 9 of which underwent full-Text review. There is limited and conflicting Class III evidence from 2 studies. CONCLUSION: Currently, there is insufficient data to conclude that ventricular size and morphology impact neurocognitive development. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-5.

AB - BACKGROUND: Myelomeningocele (MM) is the most common congenital anomaly to affect the nervous system and affects 1500-2000 newborn infants per year in the United States. It is accompanied by symptomatic hydrocephalus in approximately 70%-80% of patients. Different treatment strategies for hydrocephalus characteristically result in different effects on the size of the ventricles. OBJECTIVE: The objective of this systematic review was to determine whether persistent ventricular enlargement adversely impacts neurocognitive development in patients with MM. METHODS: The PubMed National Library of Medicine Medline database and Embase were queried using MeSH headings and keywords relevant to neurocognitive or intellectual development and ventricular size or morphology. Abstracts were reviewed by the authors to identify which studies met strict inclusion criteria. An evidence table was constructed that summarized the included studies and reflected the quality of evidence (Classes I-III) that each represented. A recommendation was made that is based on the quality of the evidence. RESULTS: An initial abstract review utilizing strict inclusion/exclusion criteria yielded 48 studies, 9 of which underwent full-Text review. There is limited and conflicting Class III evidence from 2 studies. CONCLUSION: Currently, there is insufficient data to conclude that ventricular size and morphology impact neurocognitive development. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-5.

UR - http://www.scopus.com/inward/record.url?scp=85071569704&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071569704&partnerID=8YFLogxK

U2 - 10.1093/neuros/nyz265

DO - 10.1093/neuros/nyz265

M3 - Article

VL - 85

SP - E414-E416

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 3

M1 - nyz265

ER -