Aim: To assess cognitive functions in a population-based group of children wi th hydrocephalus and to analyse differences between children with and without my elomeningo-coele (MMC); with hydrocephalus already present...Aim: To assess cognitive functions in a population-based group of children wi th hydrocephalus and to analyse differences between children with and without my elomeningo-coele (MMC); with hydrocephalus already present at birth and those who develop ed it later; children born at full term and those born preterm. Methods: Of 103 children with hydrocephalus born in the western-Swedish region in 1989-1993, 7 3 were assessed using the Wechsler Intelligence Scales or the Griffith Developme ntal Scales. Results: One-third of the children were normally gifted (IQ > 85), another 30%had a low average IQ of 70-84 and 37%had learning disabilities wi th an IQ of < 70. The median IQ was 75, verbal IQ 90 and performance IQ 76 (p < 0.001). An IQ of < 70 was found in 19 of 45 (42%) children without MMC and in 8 of 28 (29%) of those with MMC. Children born preterm had a lower IQ of 68 than those born at full term with an IQ of 76, while children with hydrocephalus pre sent at birth but without MMC had a lower IQ of 60 than the others with an IQ of 77. Children with cerebral palsy and/or epilepsy (n = 22) had a lower IQ of 66 than the IQ of 78 in those without these impairments (p < 0.01). Conclusion: Cog nitive functions in children with hydrocephalus need to be carefully assessed be fore school age to ensure adequate support and education. Even the one-third ne ar normally gifted children with an IQ of 70-85 require special attention, due to the profile of relatively well-preserved verbal functions but greatly impair ed perceptual and non-verbal abilities.展开更多
Aim: To determine the prevalence, aetiology and clinical outcome in children w ith surgically treated hydrocephalus. Methods: A population-based study of all 208 liveborn children with hydrocephalus, 124 with infantil...Aim: To determine the prevalence, aetiology and clinical outcome in children w ith surgically treated hydrocephalus. Methods: A population-based study of all 208 liveborn children with hydrocephalus, 124 with infantile hydrocephalus and 8 4 with hydrocephalus associated with myelomeningocoele, born during 1989-1998 i n western Sweden. Aetiological and clinical information was collected from recor ds. Results: The prevalence of hydrocephalus was 0.82 per 1000 live births, 0.49 for children with infantile hydrocephalus and 0.33 for children with myelomenin gocoele. The prevalence of infantile hydrocephalus decreased during the period f rom 0.55 to 0.43 per 1000. In this group, the aetiology was prenatal in 55%and peripostnatal in 44%of the children. The origin was perinatal haemorrhage in al l cases born very preterm. The mortality rate was 5%for children with either in fantile hydrocephalus or myelomeningocoele. Mental retardation, cerebral palsy a nd epilepsy were significantly more frequent in the group with infantile hydroce phalus: 46%vs 16%, 31%vs 4%and 31%vs 10%, respectively. All children with infantile hydrocephalus born very preterm had at least one of these impairments, as did 80%of those with overt hydrocephalus at birth. Conclusion: A slightly d ecreasing trend for infantile hydrocephalus was observed during the 10-y period . Children with infantile hydrocephalus had a worse outcome than those with myel omeningocoele. The need for neurosurgical revisions for two-thirds of the child ren indicates the need for further development of prevention and treatment strat egies.展开更多
文摘Aim: To assess cognitive functions in a population-based group of children wi th hydrocephalus and to analyse differences between children with and without my elomeningo-coele (MMC); with hydrocephalus already present at birth and those who develop ed it later; children born at full term and those born preterm. Methods: Of 103 children with hydrocephalus born in the western-Swedish region in 1989-1993, 7 3 were assessed using the Wechsler Intelligence Scales or the Griffith Developme ntal Scales. Results: One-third of the children were normally gifted (IQ > 85), another 30%had a low average IQ of 70-84 and 37%had learning disabilities wi th an IQ of < 70. The median IQ was 75, verbal IQ 90 and performance IQ 76 (p < 0.001). An IQ of < 70 was found in 19 of 45 (42%) children without MMC and in 8 of 28 (29%) of those with MMC. Children born preterm had a lower IQ of 68 than those born at full term with an IQ of 76, while children with hydrocephalus pre sent at birth but without MMC had a lower IQ of 60 than the others with an IQ of 77. Children with cerebral palsy and/or epilepsy (n = 22) had a lower IQ of 66 than the IQ of 78 in those without these impairments (p < 0.01). Conclusion: Cog nitive functions in children with hydrocephalus need to be carefully assessed be fore school age to ensure adequate support and education. Even the one-third ne ar normally gifted children with an IQ of 70-85 require special attention, due to the profile of relatively well-preserved verbal functions but greatly impair ed perceptual and non-verbal abilities.
文摘Aim: To determine the prevalence, aetiology and clinical outcome in children w ith surgically treated hydrocephalus. Methods: A population-based study of all 208 liveborn children with hydrocephalus, 124 with infantile hydrocephalus and 8 4 with hydrocephalus associated with myelomeningocoele, born during 1989-1998 i n western Sweden. Aetiological and clinical information was collected from recor ds. Results: The prevalence of hydrocephalus was 0.82 per 1000 live births, 0.49 for children with infantile hydrocephalus and 0.33 for children with myelomenin gocoele. The prevalence of infantile hydrocephalus decreased during the period f rom 0.55 to 0.43 per 1000. In this group, the aetiology was prenatal in 55%and peripostnatal in 44%of the children. The origin was perinatal haemorrhage in al l cases born very preterm. The mortality rate was 5%for children with either in fantile hydrocephalus or myelomeningocoele. Mental retardation, cerebral palsy a nd epilepsy were significantly more frequent in the group with infantile hydroce phalus: 46%vs 16%, 31%vs 4%and 31%vs 10%, respectively. All children with infantile hydrocephalus born very preterm had at least one of these impairments, as did 80%of those with overt hydrocephalus at birth. Conclusion: A slightly d ecreasing trend for infantile hydrocephalus was observed during the 10-y period . Children with infantile hydrocephalus had a worse outcome than those with myel omeningocoele. The need for neurosurgical revisions for two-thirds of the child ren indicates the need for further development of prevention and treatment strat egies.
