Komolafe Edward O, Komolafe Morenikeji A, Adeolu Augustine A
Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
Br J Neurosurg. 2008 Dec;22(6):764-8. doi: 10.1080/02688690802485113.
Gross congenital lesions of the nervous system are obvious at birth and usually present early for management and corrective surgery. However in tropical and developing nations, late presentations are common.
To determine the factors responsible for very late presentations of gross congenital lesions.
We conducted a prospective study of all cases of congenital CNS anomalies that presented very late (>6 months after birth) to our neurosurgical clinic over an eight year period (2000-2008).
A total of 81 patients were seen during the study period. The age ranged from 6 months to 47 years. Hydrocephalus accounted for about half of the cases 37 (48.3%). The others were spina bifida 15 (18.5%), encephalocele 10 (12.4%), subgaleal inclusion dermoid cyst 7 (8.6%), and craniosynostosis 6 (7.4%), neurofibroma 4(4.9%), and anencephaly 2 (2.5%). Reasons given for late presentations were ignorance, poverty and in some the expectation that the baby would die. Other reasons for late presentation were that the patient was either about to start school or get married.
Late presentations of congenital CNS lesions are associated with many complications most of which could have been avoided with early medical treatment. Health education should include issues regarding congenital malformations delivered by trained experts.
神经系统的明显先天性病变在出生时就很明显，通常会早期就诊以进行管理和矫正手术。然而，在热带和发展中国家，就诊延迟很常见。
确定导致严重先天性病变就诊延迟的因素。
我们对在八年期间（2000 - 2008年）到我们神经外科诊所就诊延迟（出生后>6个月）的所有先天性中枢神经系统异常病例进行了前瞻性研究。
在研究期间共诊治了81例患者。年龄范围从6个月到47岁。脑积水约占病例的一半，为37例（48.3%）。其他病例包括脊柱裂15例（18.5%）、脑膨出10例（12.4%）、帽状腱膜下包涵性皮样囊肿7例（8.6%）、颅缝早闭6例（7.4%）、神经纤维瘤4例（4.9%）和无脑儿2例（2.5%）。就诊延迟的原因包括无知、贫困，还有一些人认为婴儿会夭折。其他就诊延迟的原因是患者即将上学或结婚。
先天性中枢神经系统病变就诊延迟会引发许多并发症，其中大多数通过早期治疗本可避免。健康教育应包括由专业人员讲解先天性畸形的相关问题。
