<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic ch...<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic chronic hydrocephalus of the adult (ICHA) is increasing in Guinea due to the aging of the population. The goal of this study was to describe its epidemiology, clinical presentation, and surgical outcome in a low-resource medical environment. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Sixteen patients operated for a probable ICHA were prospectively studied according to a uniform protocol</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">from June 2019 to December 2020. On computerized tomography, all operated patients had a clinical triad of gait disturbance, incontinence, dementia associated with ventriculomegaly, and transependymal edema. In addition, all patients underwent a single lumbar tap, improved clinically, and were subsequently offered a shunt consisting of a simple catheter in 37.5% and a non-adjustable high-pressure valve in 62.5%. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">The mean age was 68.31 </span></span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.4 (range 49</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">89). The sex ratio H/F was 1.67/1. Clinically, the most frequent comorbidity was a combination of hypertension and diabetes in 56.5% of cases.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The mean time to diagnosis was 8.31 ± 2.75 months (range 3 - 14). The immediate postoperative mortality was 12.5% from a status epilepticus and pulmonary sepsis. In addition, we observed 2 cases of chronic subdural hematoma (12.5%) and 2 cases of shunt dysfunction</span><span style="font-family:""> </span><span style="font-family:Verdana;">(12.5%) in the first three months. The functional outcome was good in 23% of patients at one month (N</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">13), 50% at three months (N = 10), and 87.5% at six months (N = 8). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In carefully selected cases, the surgical outcome of ICHA in Guinea </span></span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> comparable to high-income countries. Efforts need to be put in helping patients get covered with universal insurance and generally promote Neurosurgery in the country to improve the quality of care.展开更多
Objective： The management of se- condary normal pressure hydrocephalus （sNPH） is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible fac- tors influenci...Objective： The management of se- condary normal pressure hydrocephalus （sNPH） is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible fac- tors influencing prognosis and provide theoretical basis for clinical treatment of sNPH. Methods： A retrospective study was carried out to investigate the results of 31 patients with sNPH who under- went ventriculoperitoneal shunt surgery from January 2007 to December 2011. We processed the potential influencing factors by univariate analysis and the result further by mul- tivariate logistic regression analysis. Results： Factors including age, disease duration and Glasgow coma scale （GCS） score before surgery significantly influenced the prognosis of sNPH （P〈0.05）. Further logistic regression analysis showed that all the three factors are independent influencing factors. Conclusion： Age, disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH.展开更多
文摘<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic chronic hydrocephalus of the adult (ICHA) is increasing in Guinea due to the aging of the population. The goal of this study was to describe its epidemiology, clinical presentation, and surgical outcome in a low-resource medical environment. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Sixteen patients operated for a probable ICHA were prospectively studied according to a uniform protocol</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">from June 2019 to December 2020. On computerized tomography, all operated patients had a clinical triad of gait disturbance, incontinence, dementia associated with ventriculomegaly, and transependymal edema. In addition, all patients underwent a single lumbar tap, improved clinically, and were subsequently offered a shunt consisting of a simple catheter in 37.5% and a non-adjustable high-pressure valve in 62.5%. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">The mean age was 68.31 </span></span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.4 (range 49</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">89). The sex ratio H/F was 1.67/1. Clinically, the most frequent comorbidity was a combination of hypertension and diabetes in 56.5% of cases.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The mean time to diagnosis was 8.31 ± 2.75 months (range 3 - 14). The immediate postoperative mortality was 12.5% from a status epilepticus and pulmonary sepsis. In addition, we observed 2 cases of chronic subdural hematoma (12.5%) and 2 cases of shunt dysfunction</span><span style="font-family:""> </span><span style="font-family:Verdana;">(12.5%) in the first three months. The functional outcome was good in 23% of patients at one month (N</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">13), 50% at three months (N = 10), and 87.5% at six months (N = 8). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In carefully selected cases, the surgical outcome of ICHA in Guinea </span></span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> comparable to high-income countries. Efforts need to be put in helping patients get covered with universal insurance and generally promote Neurosurgery in the country to improve the quality of care.
文摘Objective： The management of se- condary normal pressure hydrocephalus （sNPH） is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible fac- tors influencing prognosis and provide theoretical basis for clinical treatment of sNPH. Methods： A retrospective study was carried out to investigate the results of 31 patients with sNPH who under- went ventriculoperitoneal shunt surgery from January 2007 to December 2011. We processed the potential influencing factors by univariate analysis and the result further by mul- tivariate logistic regression analysis. Results： Factors including age, disease duration and Glasgow coma scale （GCS） score before surgery significantly influenced the prognosis of sNPH （P〈0.05）. Further logistic regression analysis showed that all the three factors are independent influencing factors. Conclusion： Age, disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH.
