Bull K S, Kennedy C R
Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK.
Handb Clin Neurol. 2013;112:967-72. doi: 10.1016/B978-0-444-52910-7.00017-9.
There is ample evidence that many children treated for brain tumors experience long-term neurocognitive deficits. The severity of those deficits is determined by a complex interaction of the child's genetic make-up and age, neuroanatomical damage caused by tumor and surgery, radiotherapy and chemotherapy, the psychosocial environment, and the intensity of targeted rehabilitation. The consequences of neurocognitive deficits are moderated by the number and severity of other deficits, including neurological and endocrine impairments, and this wider context must be considered. The impact of intellectual decline on academic functioning is evident, and underlies, for example, poor reading, writing, and mathematical skills. The effects of early brain damage on development are cumulative as more functions are expected to mature. Many survivors of CNS tumors can be expected to grow into deficits that have far-reaching consequences not only for academic achievement but also for their psychological and social development and their ability to be self-sufficient. Because the problems typically only become apparent over time, surveillance for their detection is an essential prerequisite for early educational and other interventions to support learning and successful transition to independent adult life.
有充分证据表明，许多接受脑瘤治疗的儿童会出现长期神经认知缺陷。这些缺陷的严重程度取决于儿童的基因构成和年龄、肿瘤及手术造成的神经解剖损伤、放疗和化疗、心理社会环境以及针对性康复的强度等复杂相互作用。神经认知缺陷的后果会因其他缺陷（包括神经和内分泌损伤）的数量和严重程度而有所缓和，必须考虑这一更广泛的背景。智力下降对学业功能的影响是明显的，例如，它是阅读、写作和数学技能差的基础。早期脑损伤对发育的影响是累积性的，因为更多功能预计会成熟。许多中枢神经系统肿瘤幸存者预计会逐渐出现缺陷，这些缺陷不仅对学业成绩有深远影响，而且对他们的心理和社会发展以及自给自足的能力也有影响。由于这些问题通常随着时间推移才会显现，因此对其进行监测是早期教育和其他支持学习及成功过渡到独立成人生活的干预措施的必要前提。
