Mori K, Shimada J, Kurisaka M, Sato K, Watanabe K
Department of Neurosurgery, Kochi Prefecture, Japan.
Brain Dev. 1995 Sep-Oct;17(5):338-48. doi: 10.1016/0387-7604(95)00070-r.
Retrospective analysis in cooperative study of hydrocephalus at institutions of members of the Research Committee on Intractable Hydrocephalus sponsored by the Ministry of Health and Welfare of Japan was performed to determine the functional prognosis for all types of hydrocephalus and thus to clarify the outcome.
In preparation of this study, we have proposed the definition, clinical classification and diagnostic criteria of hydrocephalus. We have classified non-tumoral hydrocephalus into eight types based on its etiology and the time of onset. To establish the diagnosis in each type of hydrocephalus, we have set up inclusion and exclusion criteria, as well as supplementary criteria which are useful for its diagnosis.
Analysis of the 1450 cases of hydrocephalus of various etiologies stored in the data base obtained from the study for each type of hydrocephalus revealed that following types and conditions were associated with a neurologic deficit: (1) early fetal hydrocephalus, (2) overt neonatal hydrocephalus, (3) hydrocephalus associated with such severe brain malformations as hydranencephaly, holoprosencephaly and lissencephaly, (4) hydrocephalus associated with severe brain damage, (5) hydrocephalus associated with epilepsy, (6) hydrocephalus shunted late after detection, and (7) hydrocephalus complicated by a shunting operation.
The postnatal functional outcome was significantly poor in fetal hydrocephalus diagnosed in the early gestation. Childhood onset hydrocephalus showed a poorer outcome than adult hydrocephalus.
对由日本厚生省资助的难治性脑积水研究委员会成员机构开展的脑积水合作研究进行回顾性分析，以确定各类脑积水的功能预后，从而明确其结局。
在本研究筹备过程中，我们提出了脑积水的定义、临床分类及诊断标准。我们根据病因和发病时间将非肿瘤性脑积水分为八类。为确诊每种类型的脑积水，我们制定了纳入和排除标准以及有助于诊断的补充标准。
对从各类脑积水研究中获取的数据库里存储的1450例不同病因脑积水病例进行分析后发现，以下类型和情况与神经功能缺损相关：（1）胎儿早期脑积水；（2）明显的新生儿脑积水；（3）与无脑儿、前脑无裂畸形和无脑回畸形等严重脑畸形相关的脑积水；（4）与严重脑损伤相关的脑积水；（5）与癫痫相关 的脑积水；（6）检测后较晚进行分流的脑积水；（7）并发分流手术的脑积水。
妊娠早期诊断出的胎儿脑积水出生后的功能结局明显较差。儿童期发病的脑积水结局比成人脑积水更差。
