What procedure may be performed to manage hydrocephalus in individuals with spina bifida?

• A. Placement of a shunt in the brain to drain excess CSF.
• B. Removal of the brain.
• C. Transplantation of spinal cord.
• D. External drainage of CSF without a shunt.

Answer: (A)

Managing hydrocephalus in spina bifida hinges on diverting CSF to relieve pressure inside the skull. When CSF accumulates, it enlarges the ventricles and raises intracranial pressure, which can affect brain development and function. The most effective and commonly used approach is to place a shunt that connects the brain’s ventricles to another part of the body, usually the peritoneal cavity. This creates a continuous pathway for CSF to drain, lowering ventricular size and intracranial pressure and helping protect neurological development.

The other options don’t address the ongoing CSF buildup in a practical or safe way. Removing the brain is not a viable or ethical treatment. Transplanting the spinal cord does not treat hydrocephalus. External drainage without a shunt may relieve pressure temporarily but is not a feasible long-term solution and carries risks like infection and frequent interventions. Shunt systems, though not without potential complications, provide a durable, internal means to control CSF flow and pressure as the child grows.