进行性脑积水的症状和体征。
Symptoms and signs of progressive hydrocephalus.
作者信息
Kirkpatrick M, Engleman H, Minns R A
机构信息
Department of Neurology, Royal Hospital for Sick Children, Edinburgh.
出版信息
Arch Dis Child. 1989 Jan;64(1):124-8. doi: 10.1136/adc.64.1.124.
The clinical features of 107 cases of children with hydrocephalus and measured raised intraventricular pressure were analysed retrospectively. Fifty one children had recently been diagnosed as having hydrocephalus, and the remainder had had shunts injected to direct the cerebrospinal fluid. The most common symptoms in the group were vomiting, behavioural changes, drowsiness, and headaches. The most common clinical signs were inappropriately increasing occipitofrontal head circumferences, tense anterior fontanelles, splayed sutures, and distension of the scalp veins. Half the infantile cases of hydrocephalus were without symptoms, and a quarter of the cases with cerebrospinal fluid shunts and measured raised intraventricular pressure were without signs. There were no fewer than 33 different clinical signs including several unusual ones, such as macular rash and sweating. We believe that the presentation of hydrocephalus with raised intraventricular pressure is sufficiently variable, unusual, or even absent to justify the direct measurement of intracranial pressure.
回顾性分析了107例脑积水患儿且测量到脑室压力升高的临床特征。51名儿童最近被诊断为患有脑积水，其余儿童已接受分流术以引导脑脊液。该组中最常见的症状是呕吐、行为改变、嗜睡和头痛。最常见的临床体征是枕额头围不适当增加、前囟紧张、颅骨缝增宽和头皮静脉扩张。半数婴儿脑积水病例无症状，四分之一接受脑脊液分流术且测量到脑室压力升高的病例无体征。临床体征不少于33种，包括一些不寻常的体征，如黄斑疹和出汗。我们认为，伴有脑室压力升高的脑积水表现差异很大、不常见甚至不存在，因此有必要直接测量颅内压。
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