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Materials and methods From Dec. 2007 until Dec. 2008 all children over 6 years of age treated with hydrocephalus in our institute were included. The children received an ophthalmological investigation concerning strabismus and binocular function, ophthalmoscopy, visual acuity and refraction. The special focus was visual field diagnosis, which we made with all children having cognitive conditions. The investigation was made by using the 'Goldmann' perimeter (static perimetry). Children with and without visual field defects were compared concerning age at the time of ophthalmological examination, genesis of hydrocephalus and FOH of current CT or MRI scans.

Materials and methods A nine items questionnaire created by Kulkarni (2006) was used to analyse parents concerns specifically. The answers were graduated from "not at all true" to " very true " in a 5-point adjectival scale. Parents were asked to rate how concerned they were about each item. We collected also information about age, education, job and partnership and in addition about general health status, genesis of hydrocephalus, count of revisions, epilepsy and shunt infections. We analysed questionnaires completed by 37 mothers and 6 fathers of 43 children with shunted hydrocephalus (19 females, 24 males, mean age 10 y 2 mo).

Background Eagerly awaiting the results of the Management of Myelomeningocele Study (MOMS) and with an increasing interest in setting up intrauterine myelomeningocele repair (IUMR), the optimal management of patients suffering from congenital myelomeningocele (MMC) has become a matter of debate again. We performed a cross-sectional study at our referral-center for MMC to determine the outcome for our expectantly managed patients. Materials and methods A computed chart review at our institution revealed 70 patients suffering from MMC. Forty-three patients were eligible for the study and analyzed further. A retrospective analysis was performed only in patients that underwent MMC repair within the first two days of life and were seen at our outpatient clinic between 2008 and 2009 for a regular multidisciplinary follow-up. Data were collected on: gestational age (GA) and weight at birth, age at shunt placement and shunt status after the first year of life, radiological evidence for Arnold-Chiari malformation (ACM) and tethered cord (TC), need for surgery for TC, bladder function, lower leg function and educational level. Data were compared to published results for IUMR and to studies of historical controls. Results Patients were born with MMC between 1979 and 2009 and are now 13.3 ± 8.9 (mean ± SD) years of age. At birth, mean GA was 37.8 ± 2.3 weeks and mean weight was 2921.3 ± 760.3 g, both significantly higher than in IUMR patients. Shunt placement in our cohort was required in 69.8% at a mean age of 16.0 ± 10.7 days, which was less frequent than for historical controls. Amongst our cohort, radiological observations showed 57.1% had ACM II and 41.9% had TC. Only two of our patients underwent a surgical correction for TC. Clean intermittent catheterization was performed in 69.7% of our patients, 56.4% were (assisted) walkers and 64.1% attended regular classes, both comparable to historical controls. Conclusions With a close and interdisciplinary management by pediatric surgeons, neurologists and urologists, the long-term outcome of patients suffering from MMC can currently be considered satisfactory. With respect to the known drawbacks of fetal interventions for mother and child, especially preterm delivery, the results of the MOMS trial should be awaited with caution before proceeding with a complex intervention like IUMR.

Background Arachnoid cysts are relatively rare. True cysts are congenital. Secondary cysts may result from postinflammatory accumulation of CSF in the subarachnoid space. This examination focussed exclusively on primary cysts. There is a controversy regarding the role and the type of surgery indicated in its treatment. The distribution, clinical features and treatment modalities in different types of arachnoid cysts in our patients are analysed in this study.