Maixner W J, Morgan M K, Besser M, Johnston I H
Department of Neurosurgery, Royal Alexandria Hospital for Children, Sydney, Australia.
Pediatr Neurosurg. 1990;16(4-5):191-6. doi: 10.1159/000120525.
The present study examines ventricular volume before and after shunting in 16 infants with hydrocephalus and mixed aetiology and relates this parameter to rates of cerebrospinal fluid clearance, intracranial pressure and outcome. Following treatment all patients showed reduction in intracranial pressure and amelioration of the clinical manifestations of hydrocephalus. Nevertheless, 4 patients showed persistence of marked ventriculomegaly, 4 had moderate ventricular enlargement, while 8 showed small or normal ventricles. Although the series was small there appeared to be a clear correlation between persistent ventriculomegaly, poor cerebrospinal fluid clearance and poor outcome despite reduction in intracranial pressure. The question is raised as to whether pressure-determined cerebrospinal fluid drainage provides optimum treatment of hydrocephalus in infants given the particular physical characteristics pertaining to the non-rigid cranium.
本研究对16例病因复杂的脑积水婴儿分流前后的脑室容积进行了检查，并将该参数与脑脊液清除率、颅内压及预后相关联。治疗后，所有患者的颅内压均降低，脑积水的临床表现有所改善。然而，4例患者仍存在明显的脑室扩大，4例有中度脑室扩张，而8例脑室较小或正常。尽管该系列病例数较少，但尽管颅内压降低，持续性脑室扩大、脑脊液清除不佳与预后不良之间似乎仍存在明显的相关性。鉴于婴儿非刚性颅骨的特殊生理特征，对于压力决定的脑脊液引流是否能为婴儿脑积水提供最佳治疗这一问题引发了思考。
