Central Nervous System Infections as a Limiting Factor in the Intelligence of Children with Myelomeningocele

The expectation for intellectual performance of children born with myelomeningocele has often been reported to be significantly decreased due to the presence of hydrocephalus. This study examines the medical histories as well as psychological performance scores of 167 patients observed in our multidisciplinary clinic. Based only on medical histories, the subjects were placed into one of three groups: nonshunted, shunted, and shunted with a history of ventriculitis. Their IQ scores were then compiled and resulted in the following performance breakdown of mean IQs: nonshunted, IQ = 102; shunted, IQ = 95; shunted with a history of ventriculitis, IQ = 72, There were no cases of central nervous system infections in patients who did not have hydrocephalus. Visual motor integration scores were also categorized in the same manner, illustrating a similar trend for severely depressed scores in the group that was shunted and had a history of ventriculitis, while at the same time showing the two remaining groups to be statistically similar. These results have significant importance in the management of hydrocephalus and/or infection as well as indicating the nonpredictability of simple hydrocephalus in the ultimate outcome for intellectual function of those persons born with myelomeningocele.