Lary S, De Vries L S, Kaiser A, Dubowitz L M, Dubowitz V
Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital, London.
Arch Dis Child. 1989 Jan;64(1 Spec No):17-23. doi: 10.1136/adc.64.1_spec_no.17.
Nineteen infants with posthaemorrhagic ventricular dilatation had auditory brain stem responses measured during the period of maximal ventricular dilatation. These showed various patterns ranging from normal, through various abnormalities, to complete absence of responses. When serial auditory brain stem responses were studied in parallel with the evolution of posthaemorrhagic ventricular dilatation it was seen that the abnormalities of auditory brain stem response usually resolved irrespective of the persistence or progression of ventricular dilatation. No correlation was found between cerebrospinal fluid pressure and prolonged interpeak intervals on the auditory brain stem response. In three patients with posthaemorrhagic ventricular dilatation improvement in the auditory brain stem response occurred when cerebrospinal fluid was withdrawn. Intermittent withdrawal of cerebrospinal fluid (by ventricular tap or lumbar puncture) in two of these infants was followed by improvement in the auditory brain stem response after a period of 24 hours (but not sooner). In one infant born at full term improvement in the auditory brain stem response was noted one week after shunting.
19例出血后脑室扩张的婴儿在脑室扩张最大期进行了听性脑干反应测定。结果显示出各种模式,从正常到各种异常,直至完全无反应。当将系列听性脑干反应与出血后脑室扩张的进展情况并行研究时发现,听性脑干反应异常通常会消失,而与脑室扩张的持续或进展无关。未发现脑脊液压力与听性脑干反应的峰间期延长之间存在相关性。在3例出血后脑室扩张患者中,抽出脑脊液后听性脑干反应有所改善。在其中2例婴儿中,间歇性抽出脑脊液(通过脑室穿刺或腰椎穿刺),24小时后(但不是更早)听性脑干反应得到改善。1例足月出生的婴儿在分流术后1周,听性脑干反应有改善。