45th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida

The 45th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida was held this year in Uppsala, Sweden. Our host for this Meeting was Margareta Dahl of the University Children's Hospital, Folke Bernadottehennet, Uppsala. The weather was fortunately warm and sunny throughout most of the Meeting.

During the evening reception on the 27 June 2001 at the Echlenschoft Hotel we were treated to a delightful medley of Swedish traditional songs given by children from a local choir. This was followed by tasty Swedish food and wine.

The Annual Society outing on the next day was to Skokloster Castle, on the shore of Lake Mälaren. This is one of the greatest private palaces ever built in Sweden and now houses a very impressive Baroque Museum. Construction of this castle was completed in 1676 and during our tour we were given insight into the lifestyle of Count Wrangel, a Swedish nobleman. We reached the castle by water, travelling in two riverboats, and on our return from the castle to Uppsala we all enjoyed a delicious dinner on the boats.

The Annual Dinner was held at the Uppsala Castle in the Great Hall and during the evening we enjoyed a charming display of talent from several members of Margareta Dahl's family. Her son, Thomas, played the piano and there were some beautiful songs and duets from her other children, Yohann and Helena. Finally, Linnea, who is Margareta's grandchild, put on an impressive display of gymnastics to the accompanying music played by Thomas. Leaving the castle at 10.30 pm to witness the sunset, delegates went back to their hotels to try to get to sleep before the sun rose again at 2.30 am! As a result of the splendid weather during the meeting many delegates took the opportunity of visiting other attractions in Uppsala and the surrounding regions.

During the first scientific session Dr. Hugh Richards reported the latest findings from the UK Shunt Registry. A large accumulation of data over the last few years has meant that several factors relating to shunt surgery can now be analysed. Several myths, such as the influence of timing of surgery on the shunt infection rate, have been dispelled with this important data. However, there is a danger that hidden confounding variables may emerge in such large data sets and caution must be exercised in interpreting some of the results from these analyses. During the second session, the benefits and drawbacks of surgical attempts to control urinary incontinence were discussed in several papers. The potential benefits of intrathecal Oxybutynin were explained by Dr. Buyse and the importance of regular monitoring of renal function was emphasised during this session by various speakers.

On the following day there were plenty of good quality presentations, followed by enthusiastic questions from the audience. Dr. Cochrane from Vancouver described the results of a survey of parents of patients with myelomeningocele treated by foetal surgery. Interestingly the parents felt that a very major improvement in the need for shunting, wheelchair dependency and rate of incontinence should be achieved in order to justify the substantial risk to both mother and foetus, associated with such antenatal procedures. The problems arising from appendicitis in patients with ventriculoperitoneal shunts were described by Dr. Häussler, who also reported an unusually high incidence of presumed primary appendicitis in their Austrian shunted population.

The winning essay for this year's Casey Holter Prize was submitted by Jaleel Mihan, Carole Sobkoviak and Clare Draper. They addressed the important topic of early cortical development in hydrocephalus and spina bifida. In a very thorough and inspiring essay they described the range of recent experimental work relating to disturbances of cortical cellular migration and the effects of CSF and growth factors in early brain development. The practical consequences of these early disturbances on long-term cognitive function were explained and some potential future directions for research were proposed with the ultimate goal of prevention.

PS: The editors wish to point out that the views expressed in this journal may not always reflect those of the Editors or Publishing House.