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[颅缝早闭和狭窄手术指征的神经精神方面]

[Neuropsychiatric aspects of surgical indications of craniosynostosis and -stenosis].

作者信息

Fehlow P

机构信息

Bezirkskrankenhaus für Psychiatrie Neurologie Mühlhausen.

出版信息

Zentralbl Neurochir. 1988;49(3):224-9.

PMID:3242335
Abstract

In case of an indication for an operation on craniosynostosis not only an atrophy of the optical nerve, mental retardation and epileptic fits should be taken into consideration, but also the danger of faulty psychic developments, criminality of male patients, increased occurrence of psychoses and early cerebral blood flow disturbances as well as, especially in girls with scapho- or oxycephaly, cosmetic impairments with resulting psychosocial disturbances. Convulsions in craniosynostosis are not always an expression of a generally increased intracranial pressure, sometimes genetic couplings should be taken into consideration in case of an indication for craniotomy. Disturbances of social adaptation are related to a psychic fronto-cerebral syndrome due to frontal dysplasia of the base of the skull. For carrying out a craniotomy it is advisable to employ a combination of orbito-fronto-sphenoidal osteotomy for an extension of the anterior cranial fossa.

摘要

对于颅缝早闭需要进行手术的情况,不仅要考虑视神经萎缩、智力发育迟缓及癫痫发作,还要考虑心理发育异常的风险、男性患者的犯罪倾向、精神病发病率增加、早期脑血流紊乱,以及尤其在患舟状头或尖头畸形的女孩中,因容貌受损导致的心理社会障碍。颅缝早闭时的惊厥并不总是颅内压普遍升高的表现,在有开颅手术指征的情况下有时应考虑基因关联。社会适应障碍与因颅底额叶发育异常导致的精神性额脑综合征有关。进行开颅手术时,建议采用眶额蝶骨截骨术来扩大前颅窝。

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