Author(s)

Youssouf Sogoba¹, Seybou Hassane Diallo², Issa Amadou³, Boubacar Sogoba¹, Moussa Diallo¹, Benoi Kamaté³, Daouda Mariko¹, Coulibaly Oumar⁴, Quenum Kisito⁵, Hawa Diall⁶, Leonie Diakité⁶, Salimata Diallo², Belco Maiga⁶, Fousseyni Traoré⁶, Karamoko Sacko⁶, Oumar Diallo⁴, Drissa Kanikomo¹, Youssoufa Maiga²

¹Department of Neurosurgery, Hôpital Gabriel Touré, Bamako, Mali.
²Department of Neurology, Hôpital Gabriel Touré, Bamako, Mali.
³Department of Pediatric Surgery, Hôpital Gabriel Touré, Bamako, Mali.
⁴Department of Neurosurgery, Hôpital du Mali, Bamako, Mali.
⁵Department of Neurosurgery, University Hospital of Parakou, Parakou, Benin.
⁶Department of Pediatrics, Hôpital Gabriel Touré, Bamako, Mali.

Background: Myelomeningocele (MMC) is the most common neural tube defect (NTD) characterized by the extrusion of the spinal cord into a sac filled with cerebrospinal fluid, resulting in lifelong disability. In the general population, the incidence of MMC ranges from 0.3 to 4.5/10,000 births. Live born infants with myelomeningocele have a death rate of approximately 10%. Many factors may play a role in the development of MMC such as environmental and genetic factors. In this study, we present our experience with a group of 63 children afflicted with MMC. Methods: This study was a retrospective analysis of 63 patients with MMC admitted to the neurosurgical department of Gabriel Touré Hospital from September 2017 to August 2018. A detailed history was obtained from the family at presentation. The family history and medical information before and during the pregnancy were compiled. Patients underwent complete physical and neurological examinations. Forty-seven (74.60%) patients underwent repair of the MMC and a ventriculoperitoneal shunt was placed in 12 (19%) patients with accompanying hydrocephalus. The risk factors, neurological status, and surgical results have been analyzed. Results: Of 63 children with MMC admitted to our neurosurgical department, 34 (54%) were boys and 29 (46%) were girls. Forty (63.49%) patients were the children of marriages of second cousins or closer. The mean age of the fathers was 34 years (16 - 65), while that of mothers was 26 years (16 - 38). The pregnancy was unplanned in all cases. Fourteen (22.22%) mothers had genitourinary infections, 9 (14.3%) had malaria and 57 (90.47%) mothers used analgesics and antibiotics during the pregnancy. Fifty-nine (93.65%) children were born at term, 58 (92%) were delivered via normal spontaneous vaginal delivery, and 5 (8%) via cesarean section. Lumbosacral lesions were the most frequent in 27 (42.86%) patients. Forty-seven (74.60%) patients underwent repair of the MMC and a ventriculoperitoneal shunt was placed in 12 (19%) patients with accompanying hydrocephalus. Wound infection developed in 2 cases in the postoperative period. The mortality rate was 4.3%. Conclusion: Myelomeningocele is a congenital anomaly for which several risk factors are known as well as environmental and genetic factors. This emphasizes the importance of prevention with folic acid supplementation and genetic advice.

Myelomeningocele, Neural Tube Defects, Hydrocephalus

Sogoba, Y. , Diallo, S. , Amadou, I. , Sogoba, B. , Diallo, M. , Kamaté, B. , Mariko, D. , Oumar, C. , Kisito, Q. , Diall, H. , Diakité, L. , Diallo, S. , Maiga, B. , Traoré, F. , Sacko, K. , Diallo, O. , Kanikomo, D. and Maiga, Y. (2021) Demographic and Clinical Characteristics of 63 Children with Myelomeningoceles. Open Journal of Modern Neurosurgery, 11, 59-64. doi: 10.4236/ojmn.2021.112007.