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학습 자료 둘러보기 →The most critical complication of myelomeningocele is hydrocephalus, often caused by an Arnold-Chiari II malformation. This obstructs CSF flow, leading to a rapid increase in intracranial pressure.
The earliest and most reliable sign of hydrocephalus in a neonate is a bulging anterior fontanelle accompanied by a rapidly increasing head circumference crossing percentile lines. Other late signs include sunsetting eyes, high-pitched cry, and apnea.
Do not mistake baseline neurological deficits (flaccid paralysis, absent reflexes) for acute deterioration. A bulging fontanelle is a neurological emergency requiring immediate intervention to prevent brain herniation. CSF leakage from the sac requires sterile covering but is secondary to managing rising ICP.
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