Persson E-K, Hagberg G, Uvebrant P
Department of Paediatrics, County Hospital, Halmstad, Sweden.
Neuropediatrics. 2006 Dec;37(6):330-6. doi: 10.1055/s-2007-964868.
Children with hydrocephalus represent a heterogeneous group with various aetiologies and disability profiles. Over the years, continuous changes in medical care have occurred and updated information is important.
To study disability profiles in aetiological and gestational age subgroups of children with hydrocephalus in the 1990s.
A population-based series of 114 children, 70 with infantile hydrocephalus and 44 with hydrocephalus associated with MMC. All the children were examined clinically and interviewed.
Learning disabilities were present in 47 % of children with infantile hydrocephalus compared with 16 % of those with MMC, cerebral palsy in 27 % vs. zero and epilepsy in 34 vs. 11 %. Even after excluding children with cerebral palsy, the majority had abnormal tendon reflexes and scored below the 5th centile on a motor test. Hydrocephalus overt at birth, low gestational age, a perinatal origin, enlarged ventricles at follow-up and several shunt revisions all indicated risk factors for a poor outcome.
In spite of major advances in management, hydrocephalus in children still has a considerable impact on outcome. Being born very preterm and with a hydrocephalus that is already overt at birth involve the highest risk of a poor outcome. Apart from major impairments, the children frequently have definite motor problems.
脑积水患儿是一个病因和残疾情况各异的异质性群体。多年来，医疗护理不断变化，更新信息很重要。
研究20世纪90年代脑积水患儿病因和胎龄亚组中的残疾情况。
一项基于人群的研究系列，共114名儿童，其中70名患有婴儿脑积水，44名患有与脊髓脊膜膨出相关的脑积水。所有儿童均接受临床检查和访谈。
婴儿脑积水患儿中47%存在学习障碍，而脊髓脊膜膨出患儿中这一比例为16%；脑瘫发生率分别为27%和0%；癫痫发生率分别为34%和11%。即使排除脑瘫患儿，大多数患儿仍有异常腱反射，且在运动测试中得分低于第5百分位数。出生时即出现脑积水、低胎龄、围产期病因、随访时脑室扩大以及多次分流术修订均表明预后不良的危险因素。
尽管在治疗方面取得了重大进展，但儿童脑积水对预后仍有相当大的影响。极早产且出生时即已出现脑积水的患儿预后不良风险最高。除了严重损伤外，这些儿童还经常存在明显的运动问题。
