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Abstract In this study we have discussed the multiple modalities in the management of mylomeningocele and the associated hydrocephalus in infants regarding the peri-natal diagnosis and care for cases of spina bifida, the timing of surgical intervention whether for repair of the myelomeningocele or for shunt placement, the actual need for CSF diversion and the multiple techniques for closure of the defect. We reviewed the literature and the recent publications which tried to reach the ideal way of management and the recommendations for our further practice. We recommend surgical repair of myelomeningocele as early as possible followed 5-7 days later by V-P shunt placement if it is actually indicated. |