Sakamoto Hiroaki, Kitano Shouhei
Department of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku Osaka, 534-0021, Japan.
Childs Nerv Syst. 2006 May;22(5):517-22. doi: 10.1007/s00381-005-0015-1. Epub 2006 Feb 24.
To estimate intracranial volume-buffering capacity in the event of shunt occlusion, the reexpandabilty of the lateral ventricles and clinical manifestations were examined in shunt-dependent hydrocephalic children.
This retrospective study was performed in 38 children who displayed acute deterioration due to spontaneous shunt obstruction. At the time of shunt obstruction, patients with small lateral ventricles [small ventricle (SV) group: Evans' index <or=35, n=13] showed significantly more rapid deterioration into lethargy after onset than those with large lateral ventricles [lateral ventricle (LV) group: Evans' index >0.35, n=25]. All patients in the SV group were 3 years or older at the time of shunt obstruction or had a long period (5.2 years) between initial shunting and shunt occlusion. Their Evans' index was less than 0.33 prior to shunt obstruction.
While a shunt is functioning, the factors predictive of reduced ventricular reexpandability include (1) a lateral ventricular size smaller than 0.33 on the Evans' index and (2) either an age of more than 3 years in children who have undergone initial shunting at less than 1 year of age or over 5 years of the period after initial shunting.
为评估分流梗阻时的颅内容积缓冲能力，对依赖分流的脑积水患儿的侧脑室再扩张能力及临床表现进行了研究。
本回顾性研究纳入了38例因自发性分流梗阻而急性恶化的儿童。分流梗阻时，侧脑室小的患者[小脑室（SV）组：埃文斯指数≤35，n = 13]起病后发展为嗜睡的速度明显快于侧脑室大的患者[侧脑室（LV）组：埃文斯指数>0.35，n = 25]。SV组所有患者在分流梗阻时年龄均在3岁及以上，或初次分流与分流梗阻之间间隔时间较长（5.2年）。分流梗阻前其埃文斯指数小于0.33。
在分流功能正常时，预测脑室再扩张能力降低的因素包括：（1）埃文斯指数小于0.33的侧脑室大小；（2）1岁前初次分流的儿童年龄超过3岁，或初次分流后超过5年。
