Institute of Health Sciences, University of Rzeszow, 35-959 Rzeszów, Poland.
Int J Environ Res Public Health. 2022 May 7;19(9):5712. doi: 10.3390/ijerph19095712.
Background: This study was conducted to evaluate the co-occurrence of hydrocephalus treated/untreated surgically and congenital nervous system disorders or neurological syndromes with symptoms visible since childhood, and with somatic development disorders, based on significant data obtained during admission to a neurological rehabilitation unit for children and adolescents. Methods: The study applied a retrospective analysis of data collected during hospitalization of 327 children and adolescents, aged 4−18 years, all presenting congenital disorders of the nervous system and/or neurological syndromes associated with at least one neurodysfunction that existed from early childhood. To allow the identification of individuals with somatic development disorders in the group of children and adolescents with hydrocephalus treated/untreated surgically, the adopted criteria considered the z-score values for body height, body weight, head circumference, body mass index, and head circumference index. Results: Treated/untreated hydrocephalus was observed in the study group at the rates of 8% and 0.9%, respectively. Among 239 patients with cerebral palsy, 9 (3.8%) had surgically treated hydrocephalus, 17 (70.8%) of 24 patients with neural tube defects also had hydrocephalus treated with surgery, and 3 (12.5%) of 24 patients with neural tube defects had untreated hydrocephalus. This medical condition was a more frequent comorbidity in subjects with neural tube defects compared with those with cerebral palsy (p < 0.001). Subjects with untreated hydrocephalus most frequently presented macrocephaly (p < 0.001), including absolute macrocephaly (p = 0.001), and with tall stature (p = 0.007). Excessive body mass co-occurred more frequently with surgically untreated hydrocephalus, but the relationship was not statistically significant (p = 0.098). Conclusions: Surgically treated hydrocephalus occurred in patients with cerebral palsy and neural tube defects, and untreated hydrocephalus was present only in patients with neural tube defects. Untreated hydrocephalus negatively changed the course of individual development in the studied group of children, in contrast to surgically treated hydrocephalus.
本研究旨在评估在神经康复病房住院的 327 名 4-18 岁儿童和青少年中，患有脑积水（经手术治疗/未治疗）与先天性神经系统疾病或自幼儿期起即存在的神经发育障碍相关的神经综合征并存的情况，并基于获得的重要数据进行分析。方法：本研究采用回顾性数据分析方法，对所有患有先天性神经系统疾病和/或神经综合征并伴有至少一种自幼儿期即存在的神经功能障碍的患者进行了住院治疗。为了在接受手术治疗/未治疗的脑积水患儿和青少年组中识别出存在躯体发育障碍的个体，采用了身高、体重、头围、体重指数和头围指数的 z 分数值作为纳入标准。结果：研究组中经手术治疗/未治疗的脑积水的发生率分别为 8%和 0.9%。在 239 例脑瘫患者中，有 9 例（3.8%）患有经手术治疗的脑积水，24 例神经管缺陷患者中有 17 例（70.8%）也患有经手术治疗的脑积水，24 例神经管缺陷患者中有 3 例（12.5%）患有未经治疗的脑积水。与脑瘫患者相比，神经管缺陷患者的脑积水更易并发（p<0.001）。未经治疗的脑积水患者最常表现为大头畸形（p<0.001），包括绝对大头畸形（p=0.001）和身材高大（p=0.007）。与未经治疗的脑积水相关的超重更常见，但无统计学意义（p=0.098）。结论：在脑瘫和神经管缺陷患者中发现了经手术治疗的脑积水，而未经治疗的脑积水仅存在于神经管缺陷患者中。与经手术治疗的脑积水不同，未经治疗的脑积水对研究组患儿的个体发育过程产生了负面影响。
