Author:
McCullough David C.,Balzer-Martin Lynn A.
Abstract
✓ Chiefly because of advances in prenatal diagnostic ultrasonography, prognostic data on congenital hydrocephalus have increased in pertinence. Neurosurgeons may be confronted with requests for prognostic information after discovery of gestational hydrocephalus. Because previous reports reflect technical problems, complications, and less favorable results of an evolutionary period in hydrocephalus therapy, the authors have attempted to update the prognostic picture with a review of their results in hydrocephalus that is overt at birth. The status of 37 children treated with cerebrospinal fluid shunts after delivery at term with overt hydrocephalus was evaluated after an average 6-year follow-up period. They represented 8% of all children being followed for hydrocephalus. Outcome was also reviewed in 11 patients with severe hydrocephalus who were not treated. Of treated patients, 86% survived 1 to 16 years, while all of the untreated infants died at an average of 2.5 months. Approximately two-thirds of treated patients have normal or borderline intellectual capabilities (mean IQ 96, standard deviation 22). Dandy-Walker malformation was associated with a high mortality and a very low IQ in survivors. Congenital aqueductal atresia was also associated with intellectual impairment, but children with communicating hydrocephalus and myelomeningocele were not intellectually impaired. Among the survivors with low IQ, the poor outcome was generally predictable on the basis of cortical mantle thickness and “brain mass” calculations before therapy. The findings from this partially selected series indicate that the majority of babies born with overt hydrocephalus have a good prognosis with appropriate therapy.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Cited by
116 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Ethical Issues in the Diagnosis and Management of Genetic Disorders in the Fetus;Genetic Disorders and the Fetus;2021-04-20
2. Intrapartum Management;Professional Ethics in Obstetrics and Gynecology;2019-11-14
3. The Role of Transcranial Doppler Sonography in the Management of Pediatric Hydrocephalus;The Role of Transcranial Doppler Sonography in the Management of Pediatric Hydrocephalus;2019-11-06
4. Aqueductal Stenosis and Hydrocephalus;Pediatric Hydrocephalus;2019
5. Aqueductal Stenosis and Hydrocephalus;Pediatric Hydrocephalus;2018-10-11