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良性外部性脑积水综合征患儿的神经发育特征。一项初步队列研究。

Neurodevelopmental profile in children with benign external hydrocephalus syndrome. A pilot cohort study.

机构信息

Neurotrauma and Neurosurgery Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.

ICFO - Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, Barcelona, Spain.

出版信息

Childs Nerv Syst. 2021 Sep;37(9):2799-2806. doi: 10.1007/s00381-021-05201-z. Epub 2021 May 10.

Abstract

PURPOSE

The management of children with benign external hydrocephalus (BEH) remains controversial. Most BEH children do well in the long-term, but a substantial number have temporary or permanent psychomotor delays. The study aims to assess the prevalence and pattern of neurodevelopmental delay in a cohort of children with BEH.

METHODS

We conducted a cohort study of 42 BEH children (30 boys and 12 girls, aged 6 to 38 months). A pediatric neurosurgeon performed a first clinical evaluation to confirm/reject the diagnosis according to the clinical features and neuroimaging studies. Two trained evaluators assessed the child's psychomotor development using the third edition of the Bayley Scales of Infant and Toddler Development (Bayley-III). Developmental delay was defined as a scaled score < 7 according to the simple scale and/or a composite score < 85.

RESULTS

Eighteen children (43%) presented statistically lower scores in the gross motor and composite motor of the Bayley-III scales compared to their healthy peers.

CONCLUSION

In BEH, it is important to establish a diagnostic algorithm that helps to discriminate BEH patients that have self-limiting delays from those at risk of a persistent delay that should be referred for additional studies and/or interventions that might improve the natural evolution of a disease with high impact on the children and adult's quality of life.

摘要

目的

儿童良性外部脑积水(BEH)的管理仍存在争议。大多数 BEH 患儿长期预后良好,但相当一部分患儿存在暂时性或永久性精神运动发育迟缓。本研究旨在评估 BEH 患儿队列中神经发育迟缓的患病率和模式。

方法

我们对 42 例 BEH 患儿(30 名男孩和 12 名女孩,年龄 6 至 38 个月)进行了队列研究。小儿神经外科医生根据临床特征和神经影像学研究进行首次临床评估,以确认/排除诊断。两名经过培训的评估员使用贝利婴幼儿发展量表第三版(Bayley-III)评估儿童的精神运动发育。根据简单量表和/或综合量表<85 分,将发育迟缓定义为评分<7。

结果

18 名儿童(43%)的 Bayley-III 量表的粗大运动和综合运动评分明显低于健康同龄人。

结论

在 BEH 中,建立有助于区分具有自限性延迟的 BEH 患者和有持续性延迟风险的患者的诊断算法非常重要,后者应转介进行额外的研究和/或干预,以改善对儿童和成人生活质量影响较大的疾病的自然演变。

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