Cognitive changes after cerebrospinal fluid shunting in young adults with spina bifida and assumed arrested hydrocephalus

Objectives-To establish whether surgery can improve the neuropsychological functioning of young adult patients with spina bifida and apparent clinical ly arrested hydrocephalus showing abnormal intracranial pressure. Methods-Twenty three young adults with spina bifida and assumed arrested hy drocephalus (diagnosed as active or compensated by continuous intracranial pressure monitoring) underwent surgery. All patients received neuropsycholo gical examination before surgery and 6 months later. Neuropsychological ass essment included tests of verbal and visual memory, visuospatial functions, speed of mental processing, and frontal lobe functions. Results-Shunt placement in this subgroup of patients improves neuropsycholo gical functioning, especially in verbal and visual memory and attention and cognitive flexibility. Conclusions-Young adults with spina bifida and suspected non-functioning sh unt or non-shunted ventriculomegaly should be carefully monitored to identi fy those who could benefit from shunting.