Bauru Medical School, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Childs Nerv Syst. 2022 Oct;38(10):1849-1854. doi: 10.1007/s00381-022-05615-3. Epub 2022 Jul 30.
Myelomeningocele (MMC) is the most frequent neural tube defect and is frequently associated (around 80% of cases) with hydrocephalus (HC). Both diseases can have severe clinical consequences, insomuch as they require surgical treatment whose complications are not negligible, either when performed in utero or after birth. Therefore, clinical therapies that could have an impact on the incidence and progression of MMC and HC would be certainly valuable; however, this is not the current picture, and there are no effective pharmacological treatments for such patients to this day.
Therefore, knowing that an inflammatory process comes associated with these disorders, mostly due to nervous tissue distension, the present article aimed at reviewing the role of corticosteroids in reducing inflammation and thus improving the outcome of patients with HC and MMC, considering the well-established anti-inflammatory effects of CS.
The systematic review performed herein has found varying results regarding the role of steroids (even though a positive trend was observed) on the treatment and prevention of hydrocephalus, whereas for MMC.
There are many reports demonstrating beneficial effects of CS therapy, from a clinical and histopathological point of view.
脊髓脊膜膨出（MMC）是最常见的神经管缺陷，常伴有脑积水（HC）（约 80%的病例）。这两种疾病都可能有严重的临床后果，因为它们都需要手术治疗，而手术治疗的并发症不容忽视，无论是在宫内还是出生后进行。因此，如果有一种能够对 MMC 和 HC 的发病率和进展产生影响的临床疗法，那将是非常有价值的；然而，目前的情况并非如此，至今尚无针对此类患者的有效药物治疗方法。
鉴于炎症过程与这些疾病有关，主要是由于神经组织的膨胀，因此，本文旨在回顾皮质类固醇在减轻炎症方面的作用，从而改善 HC 和 MMC 患者的预后，考虑到 CS 的明确抗炎作用。
本文进行的系统评价发现，皮质类固醇（尽管观察到积极趋势）在治疗和预防脑积水方面的作用存在差异，而对于 MMC 则不然。
有许多报告从临床和组织病理学的角度证明了 CS 治疗的有益效果。
