Progressive hydrocephalus in teenage spina bifida patients.

: Many spina bifida patients with shunts for hydrocephalus do not require shunt revisions for several years. These children are often considered to be no longer shunt dependent, only to develop rising intracranial pressure (ICP) requiring surgery in the second decade. We present three patients who, despite never having had a C.S.F. shunt, developed rising intracranial pressure in early teenage years. The diagnosis was delayed because of the lack of appreciation of this clinical entity. One child died, the second suffered permanent neurological damage, and the third recovered completely. We suggest that both shunted and non-shunted patients have a common cause for the late rise in ICP.