Ceddia A, Di Rocco C, Iannelli A, Lauretti L
Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Roma.
Minerva Pediatr. 1992 Sep;44(9):445-50.
Two hundred eight patients with non-tumoral congenital hydrocephalus underwent CSF shunting below the age of one month. Ultrasonography was the most frequently utilized tool; hydrocephalus was recognized during pregnancy in 52% of the cases. Hydrocephalus was associated with myelomeningocele in 97 infants; in 38 subjects ventricular dilation was secondary to aqueductal stenosis. Post-hemorrhagic and post-infective hydrocephalus accounted for only 20 and 13 cases respectively. At the follow-up observation, a normal psychomotor development was recorded in 67.3% of the cases. Seventeen patients died. CSF infection was the most common cause of death (41%); in 6 patients the exitus was determined by the natural evolution of congenital associated malformations. Shunt revision did not influence the morbidity and the mortality significantly. On the other hand, CSF infections appeared to influence the prognosis negatively. In our experience, the prognosis of hydrocephalus operated on in the first month of life does not differ from that of hydrocephalus operated on late in life.
208例非肿瘤性先天性脑积水患儿在1月龄前接受了脑脊液分流术。超声检查是最常用的工具;52%的病例在孕期就已确诊脑积水。97例患儿的脑积水与脊髓脊膜膨出有关;38例患儿的脑室扩张继发于导水管狭窄。出血后和感染后脑积水分别仅占20例和13例。在随访观察中,67.3%的病例记录到精神运动发育正常。17例患儿死亡。脑脊液感染是最常见的死亡原因(41%);6例患儿的死亡是由先天性相关畸形的自然发展所致。分流术的修订对发病率和死亡率没有显著影响。另一方面,脑脊液感染似乎对预后有负面影响。根据我们的经验,出生后第一个月接受手术治疗的脑积水患儿的预后与晚些时候接受手术治疗的脑积水患儿的预后没有差异。