The choroid plexus-cerebrospinal fluid interface in Alzheimer's disease:more than just a barrier

The choroid plexus is a complex structure which hangs inside the ventricles of the brain and consists mainly of choroid plexus epithelial（CPE） cells surrounding fenestrated capillaries.These CPE cells not only form an anatomical barrier,called the blood-cerebrospinal fluid barrier（BCSFB）,but also present an active interface between blood and cerebrospinal fluid（CSF）.CPE cells perform indispensable functions for the development,maintenance and functioning of the brain.Indeed,the primary role of the choroid plexus in the brain is to maintain homeostasis by secreting CSF which contains different molecules,such as nutrients,neurotrophins,and growth factors,as well as by clearing toxic and undesirable molecules from CSF.The choroid plexus also acts as a selective entry gate for leukocytes into the brain.Recent findings have revealed distinct changes in CPE cells that are associated with aging and Alzheimer＇s disease.In this review,we review some recent findings that highlight the importance of the CPE-CSF system in Alzheimer＇s disease and we summarize the recent advances in the regeneration of brain tissue through use of CPE cells as a new therapeutic strategy.

Neural differentiation of choroid plexus epithelial cells:role of human traumatic cerebrospinal fluid

As the key producer of cerebrospinal fluid（CSF）,the choroid plexus（CP） provides a unique protective system in the central nervous system.CSF components are not invariable and they can change based on the pathological conditions of the central nervous system.The purpose of the present study was to assess the effects of non-traumatic and traumatic CSF on the differentiation of multipotent stem-like cells of CP into the neural and/or glial cells.CP epithelial cells were isolated from adult male rats and treated with human non-traumatic and traumatic CSF.Alterations in m RNA expression of Nestin and microtubule-associated protein（MAP2）,as the specific markers of neurogenesis,and astrocyte marker glial fibrillary acidic protein（GFAP） in cultured CP epithelial cells were evaluated using quantitative real-time PCR.The data revealed that treatment with CSF（non-traumatic and traumatic） led to increase in m RNA expression levels of MAP2 and GFAP.Moreover,the expression of Nestin decreased in CP epithelial cells treated with non-traumatic CSF,while treatment with traumatic CSF significantly increased its m RNA level compared to the cells cultured only in DMEM/F12 as control.It seems that CP epithelial cells contain multipotent stem-like cells which are inducible under pathological conditions including exposure to traumatic CSF because of its compositions.

Clinical analysis of four cases of intracranial choroid plexus cysts

Objective To summarize and report the diagnosis and management of choroid plexus cysts. Methods The clinical data of 4 choroid plexus cysts cases from March 2005 and 2010 March were analyzed retrospectively,and pathology appearances,surgical treatment were evaluated. Results Intracranial cystic lesion

Cell transplantation for the treatment of spinal cord injury–bone marrow stromal cells and choroid plexus epithelial cells

Transplantation of bone marrow stromal cells （BMSCs） enhanced the outgrowth of regenerating axons and promoted locomotor improvements of rats with spinal cord injury （SCI）. BMSCs did not survive long-term, disappearing from the spinal cord within 2-3 weeks after transplantation. Astrocyte-devoid areas, in which no astrocytes or oligodendrocytes were found, formed at the epicenter of the lesion. It was remarkable that numerous regenerating axons extended through such astrocyte-devoid areas. Regenerating axons were associated with Schwann cells embedded in extracellular matrices. Transplantation of choroid plexus epithelial cells （CPECs） also enhanced axonal regeneration and locomotor improvements in rats with SCI. Although CPECs disappeared from the spinal cord shortly after transplantation, an extensive outgrowth of regenerating axons occurred through astrocyte-devoid areas, as in the case of BMSC transplantation. These findings suggest that BMSCs and CPECs secret neurotrophic factors that promote tissue repair of the spinal cord, including axonal regeneration and reduced cavity formation. This means that transplantation of BMSCs and CPECs promotes ＂intrinsic＂ ability of the spinal cord to regenerate. The treatment to stimu- late the intrinsic regeneration ability of the spinal cord is the safest method of clinical application for SCI. It should be emphasized that the generally anticipated long-term survival, proliferation and differentiation of transplanted cells are not necessarily desirable from the clinical point of view of safety.

Release of interleukin-10 and neurotrophic factors in the choroid plexus：possible inductors of neurogenesis following copolymer-1 immunization after cerebral ischemia

Copolymer-1（Cop-1） is a peptide with immunomodulatory properties, approved by the Food and Drug Administration of United States in the treatment of multiple sclerosis. Cop-1 has been shown to exert neuroprotective effects and induce neurogenesis in cerebral ischemia models. Nevertheless, the mechanism involved in the neurogenic action of this compound remains unknown. The choroid plexus（CP） is a network of cells that constitute the interphase between the immune and central nervous systems, with the ability to mediate neurogenesis through the release of cytokines and growth factors. Therefore, the CP could play a role in Cop-1-induced neurogenesis. In order to determine the participation of the CP in the induction of neurogenesis after Cop-1 immunization, we evaluated the gene expression of various growth factors（brain-derived neurotrophic factor, insulin-like growth factor 1, neurotrophin-3） and cytokines（tumor necrosis factor alpha, interferon-gamma, interleukin-4（IL-4）, IL-10 and IL-17）, in the CP at 14 days after ischemia. Furthermore, we analyzed the correlation between the expression of these genes and neurogenesis. Our results showed that Cop-1 was capable of stimulating an upregulation in the expression of the genes encoding for brain-derived neurotrophic factor, insulin-like growth factor 1, neurotrophin-3 and IL-10 in the CP, which correlated with an increase in neurogenesis in the subventricular and subgranular zone. As well, we observed a downregulation of IL-17 gene expression. This study demonstrates the effect of Cop-1 on the expression of growth factors and IL-10 in the CP, in the same way, presents a possible mechanism involved in the neurogenic effect of Cop-1.

The expressions of brain-derived neurotrophic factor and nerve growth factor in purified rat choroid plexus epithelial cells in vitro

Objective: To detect the expressions of brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) in purified rat choroid plexus epithelial cells in vitro. Methods: Primary and passage choroid plexus epithelial cells were obtained from newborn, one-day Sprague-Dawley rats. The expressions of BDNF and NGF were measured by qRT-PCR and Western blottingting. The secretions of BDNF and NGF were detected by ELISA. Cell supernatants of primary cells, purified cells and passage 1 cells were harvested. Results: The expression of BDNF in the purified cells was significantly lower than that in the primary cells(P<0.05), and it in the primary cells and the purified cells was significantly higher than that in the passage 1 cells(P<0.05). The expression of NGF was significantly higher in the purified cells than in the primary cells and the passage 1 cells(P<0.05). It in the passage 1 cells was significantly higher than that in the primary cells(P<0.05). Conclusion: The time of CPECs transplantation for central nervous system diseases should be selected based on their secretory function and features,which could lead to better and more effective treatment.

Endoscopic Third Ventriculostomy with or without Choroid Plexus Coagulation for Treatment of Hydrocephalus in Guinea: Analysis of 76 Cases in the Department of Neurosurgery of Kipe, Conakry

In low-income countries, endoscopic third ventriculostomy (ETV) with or without choroid plexus coagulation (CPC) is an increasingly accepted alternative to shunt therapy in adult and pediatric hydrocephalus. The authors report the result of this treatment in Conakry in a mixed population of adult and pediatric patients regardless of the etiology of the hydrocephalus. A retrospective study was conducted on 76 patients undergoing 89 ETV from January 2013 to September 2020. The predominant group of patients was infants less than one year with a mean age of 4.3 months and extremes of 1 - 8 months. The H/F sex ratio was 1.7/1. All patients presented acutely with signs of high intracranial pressure. Post-infectious causes and malformations and tumors were the main etiologies, respectively 21%, 47.3%, and 15.7%. The mean duration of the endoscopic procedures was 49.93 ± 10.9 mm, associated with a choroid plexus coagulation in 42% of cases. The complication rate in the first month was 22%, with CSF leak (5%) and death (11%) accounting for the majority. At three months, the complications rates were 45%, with 14.4% closed stroma, 6% epilepsy, and 24% mortality. The mean follow-up was 28 months (range 2 - 53), and the global success rate of 61%. Our study, with its limitations, shows that ETV with CPC is a safe primary approach for the treatment of hydrocephalus in low-income countries regardless of the etiology and the age of the patients.

High Blood Pressure Effects on the Brain Barriers and Choroid Plexus Secretion

High blood pressure produces ventricular dilation, variations in circumventricular organs and changes in the cerebrospinal fluid compositions. On the other hand, chronic hypertension in spontaneously hypertensive rats can cause changes in the integrity of the brain barriers: blood-cerebrospinal fluid barrier and blood brain barrier. The permeability of the brain barriers can be studied by using transthyretin and S-100β. In the present work we study the integrity of the brain barrier and the choroid plexus function variations in arterial hypertension. Control rats and spontaneously hypertensive rats were used and the choroid plexus were processed by immunohistochemistry with anti-transthyretin and anti-vasopressin. Western blot was also performed in cerebrospinal fluid, serum and choroid plexus using anti-S-100β, anti-transthyretin. The accumulation of transthyretin immunoreactive was bigger in spontaneously hypertensive rats with respect to the control. Vasopressin was also higher in spontaneously hypertensive rats with respect to the control. Western blot showed that transthyretin tetramer was higher in the spontaneously hypertensive rats than in the control rats. The expression of transthyretin monomer was lower in hypertensive rats than the control in the cerebrospinal fluid, the transthyretin monomer reaction in the blood was stronger in hypertensive than in control rats. Western blot for the S-100 β showed an increase in blood and cerebrospinal fluid of hypertensive rats. The high blood pressure produces a disruption of the blood brain barrier and blood to cerebrospinal fluid barrier that allows extravasations from the cerebrospinal fluid to the blood and from the blood to the cerebrospinal fluid.

Choroid Plexus Carcinoma: A Rare Tumor in Adult

Background: Choroid plexus carcinoma is a highly aggressive malignant, infrequent tumor with poor prognosis. About 80% of choroid plexus carcinoma occurs in children, but it is uncommon in adults. Because of the rarity of the choroid plexus carcinoma, there is no established treatment protocol for this malignancy. Case Description: A 21-year-old man with past medical history of asthma presented to us with the chief complaint of morning headache for one month. His brain magnetic resonance imaging (MRI) showed a mass in the trigone and occipital horn of the left lateral ventricle. He had undergone a left occipitoparietal craniotomy, posterior interhemispheric precuneus approach with grossly total removal of the tumor. The histology examination of the tumor proved to be choroid plexus carcinoma. This patient achieved a favorable outcome after having a grossly complete surgical resection followed by postoperative adjuvant radiotherapy and chemotherapy. Conclusions: Choroid plexus carcinoma is aggressive and is associated with dismal prognosis. The 5-year survival rates for choroid plexus carcinoma vary between 10% and 50%. Currently, there is no established treatment protocol for choroid plexus carcinoma. Complete resection of this malignant tumor is the primary goal of treatment since it allows best chance of survival and improves the overall prognosis.

Transplanted choroidal plexus epithelial cells can integrate with organotypic spinal cord slices into a new system

This study aimed to evaluate the integration of transplanted choroidal plexus epithelial cells with organotypic spinal cord slices.Organotypic spinal cord slices,normally cultured for 6 days,were divided into control group(Ctrl)and transplanted group(T).The choroidal plexus epithelial cells were dissociated and primary cultured(C group).The choroidal plexus epithelial cells cultured for 6–7 days were labeled by 1,1’-dioctadecyl-3,3,3’,3’-tetramethylindocarbocyanineperchlorate(CM-Dil),and were identified by transthyretin(TTR)in immunocytochemistry.They were adjusted to the density of 0.5–1×107/ml,then 2μl cells suspension were transplanted to the spinal cord slices in the T group.The same amount of basal medium was dripped on the spinal cord slices in the Ctrl group.After 14 days of transplantation,the differentiations into neurons and astrocytes,and the synapses were identified by immunofluorescence histochemistry.At the same time,the ratios of cell differentiations and synapses in new system,and the changes of MAPK signaling pathway were tested by western blotting.The choroid plexus epithelial cells were well labeled by CM-Dil and were immune-stained by TTR in immunocytochemistry.The choroid plexus epithelial cells bodies were small when transplanted on the spinal cord slices,but big when transplanted on the polyester membrane inserts.The transplanted cells could differentiate into astrocytes,and possibly differentiate into neurons,and there were a large number of synaptophysin positive vesicles between transplanted cells and organotypic spinal cord slices in immunofluorescence histochemistry.The levels of GFAP,TUB-III and synaptophysin in the T group were higher than which in the Ctrl and C groups in western blotting(P<0.05).And the ratios of p-JNK/JNK and p-P38/P38 in the T group were significantly lower than which in the Ctrl and C groups(P<0.05).But the ratio of p-ERK/ERK in the three groups was of no significant difference.The transplanted choroidal plexus epithelial cells can integrate with organotypic spinal cord slices into a new system.

Mechanism of Cu entry into the brain:many unanswered questions

Brain tissue requires high amounts of copper(Cu)for its key physiological processes,such as energy production,neurotransmitter synthesis,maturation of neuropeptides,myelination,synaptic plasticity,and radical scavenging.The requirements for Cu in the brain vary depending on specific brain regions,cell types,organism age,and nutritional status.Cu imbalances cause or contribute to several life-threatening neurologic disorders including Menkes disease,Wilson disease,Alzheimer’s disease,Parkinson’s disease,and others.Despite the well-established role of Cu homeostasis in brain development and function,the mechanisms that govern Cu delivery to the brain are not well defined.This review summarizes available information on Cu transfer through the brain barriers and discusses issues that require further research.

脉络丛及其与衰老相关疾病的关系

脉络丛由位于基底层上的上皮细胞组成,相邻脉络丛上皮细胞之间的紧密连接形成了血脑脊液屏障,它与血脑屏障一起对大脑微环境的稳态至关重要。脉络丛上皮可向脑室分泌脑脊液、生长因子、神经肽和脂类物质,同时脉络丛也是免疫细胞进入大脑的门户。衰老和神经退行性疾病的病理生理学仍然还存在大量未知,越来越多的研究将脉络丛与这些年龄相关性疾病的病因关联起来。本文综述了目前已知的脉络丛上皮与年龄相关疾病之间的关系,以期为防治相关疾病提供新的线索。

儿童脉络丛癌12例临床特征及生存分析

背景儿童脉络丛癌(CPC)临床罕见,国内报道较少。目的 探讨儿童CPC的临床特征、治疗及结局。设计病例系列报告。方法 回顾性分析首都医科大学附属北京世纪坛医院儿科于2017年1月至2022年10月收治的手术后病理确诊的CPC患儿,随访截至2022年12月31日。截取患儿性别、诊断年龄、临床表现、治疗和随访情况,生存数据采用Kaplan-Meier法分析。主要结局指标总体生存期(OS)和无进展生存期(PFS)。结果 12例CPC患儿纳入分析,男4例,女8例;中位诊断年龄29.7(5.8~119.6)个月,起病年龄<3岁8例;肿瘤直径≥5 cm 8例,<5 cm 4例;肿瘤位于幕上9例,幕下3例;肿瘤位于脑室系统6例,脑室外累及脑实质6例;起病时发现播散转移2例,无转移10例。12例均接受肿瘤切除手术,全切8例,近全切4例。术后仅行化疗5例(42%),联合放射治疗及化疗7例(58%)。截至末次随访,8例出现肿瘤复发或进展,其中4例因肿瘤进展后死亡。平均OS(56.7±8.8)个月,1、3、5年OS率分别为(83.3±10.8)%、(66.7±13.6)%和(66.7±13.6)%。平均PFS(24.3±7.2)个月,1、3年PFS率分别为(41.7±14.2)%和(33.3±13.6)%。Kaplan-Meier单因素分析发现,肿瘤位于幕下3年OS低于幕上(χ^(2)=8.562,P=0.003);单纯化疗3年OS低于放化疗联合治疗(χ^(2)=8.488,P=0.004);不同性别、起病年龄(<3岁与3~18岁)、肿瘤直径(≥5 cm与<5 cm)、切除程度、有无转移、是否放化疗对3年PFS的影响差异均无统计学意义(P均>0.05)。结论 儿童CPC临床罕见,预后差,肿瘤位于幕下及单纯化疗为影响OS的不良预后因素。

成人枕叶非典型脉络丛乳头状瘤术后复发为脉络丛癌1例报告并文献复习

目的 分析成人枕叶非典型脉络丛乳头状瘤(ACPP)术后复发为脉络丛癌(CPC)患者的临床表现、影像学特点和治疗方法。方法 回顾性分析1例成人脑枕叶ACPP术后复发为CPC患者的临床资料,并复习相关文献。结果 头颅MRI平扫及增强扫描示:右侧枕叶侧脑室后角旁见大小约3.4 cm×4.5 cm×4.5 cm(左右×前后×上下)占位,呈不规则块状,等T_(1)、T_(2)信号,边缘见短T_(1)、T_(2)信号,周边伴有稍长T_(1)、T_(2)信号,DWI呈局部高信号,T_(2)Flair呈周围高信号,增强后病灶明显强化,其内见无强化区。气管插管全身麻醉下行枕叶占位显微镜下全切,术中见部分肿瘤组织侵犯侧脑室枕角。术后病理结果示:枕叶肿瘤组织为CPC,WHOⅢ级,侵犯侧脑室肿瘤组织为脉络丛乳头状瘤(CPP),WHO I级。术后接受瘤腔放射治疗,随访1.5 a无复发。结论 脑实质内CPC是一种高度恶性肿瘤,是ACPP术后的原位复发,无特殊临床表现及影像学特征。病理学为诊断“金标准”,手术切除联合局部放疗是可能有效的治疗方法。

侧脑室脉络丛黄色肉芽肿的磁共振DWI与ADC诊断

目的探讨磁共振DWI结合ADC值对侧脑室脉络丛黄色肉芽肿的诊断价值。方法回顾性分析江油市人民医院30例侧脑室脉络丛黄色肉芽肿,6例脉络丛囊肿,9例脉络丛肿瘤患者的MRI影像表现,观察病变形态、大小、位置,T1WI、T2WI、T2-FLAIR及DWI(b=0,1000 s/mm^(2))信号特征,分别测量脉络丛黄色肉芽肿、脉络丛囊肿、脉络丛肿瘤以及侧脑室脑脊液ADC值。结果30例脉络丛黄色肉芽肿发生于60岁及以上年龄组18例(60%),60岁以下组12例(40%)。病灶大小0.4~2.4 cm,29例位于侧脑室三角区,1例位于侧脑室体部;发生于双侧26例,单侧4例,左、右侧各2例。病灶均呈结节状,T1W表现均匀低信号,T2WI表现均匀高信号,T2-FLAIR表现为等、稍高信号,DWI表现为高信号,ADC图呈等、稍低信号,ADC值(1.85±0.38)×10^(-3)mm^(2)/s,同时测得脉络丛囊肿、脉络丛肿瘤及侧脑室脑脊液ADC值分别为(3.06±0.12)×10^(-3)mm^(2)/s、(1.45±0.24)×10^(-3)mm^(2)/s、(3.18±0.35)×10^(-3)mm^(2)/s,脉络丛黄色肉芽肿与其两两比较差异均有统计学意义(P<0.05)。结论脉络丛黄色肉芽肿好发于老年人,对称分布于双侧脑室后角,常规T1WI、T2WI与脑脊液信号相似,DWI表现为高信号,结合ADC值具有一定的诊断及鉴别诊断价值。

脉络丛癌的临床病理学分析

目的探讨脉络丛癌(CPC)的临床病理及免疫组化特征。方法收集首都医科大学宣武医院诊断的CPC共10例,总结临床病例资料、组织学以及免疫组化特征,并进行文献复习。结果10例CPC发病部位以脑室居多,侧脑室及四脑室总占比60%;其次散发在枕叶、顶叶、脑干及鞍区,占比40%。年龄0.7~14岁,中位年龄为3.0岁;男性4例,女性5例;均有不同程度的中枢神经系统疾病表现,常见为嗜睡、哭闹、头痛及脑积水等症状。影像学表现为孤立性实性肿物,镜下符合2021版CNS WHO CPC诊断标准。免疫组化表型中EMA均表现为灶状阳性,GFAP、CK、CK7和CK20均有各自比例的阳性值和阳性结果,Ki-67增殖指数为15%~50%,INI-1未见缺失。特异性较强的两个指标:Kir7.1细胞膜及细胞质表达,阳性细胞数为80%,其中1例阳性细胞数低于50%;TTR在细胞质中表达,阳性细胞数为60%。结论CPC是一种罕见的、生长迅速的、好发于婴幼儿的恶性肿瘤,EMA、GFAP、CK、CK7及CK20表达有一定的规律,Kir7.1和TTR诊断CPC特异性较强,鉴别诊断婴幼儿中枢神经系统恶性肿瘤具有一定的临床价值。

脉络丛囊肿特征用于预测胎儿染色体异常

目的评价脉络丛囊肿(CPC)特征用于预测胎儿染色体异常的价值。方法纳入112胎产前超声诊断CPC胎儿,根据染色体检查结果分为异常组(n=8)及正常组(n=104);比较组间孕妇年龄、诊断胎儿CPC时间、CPC特征及是否合并其他结构异常等因素的差异,并采用后退法行logistic回归分析,筛选预测CPC胎儿染色体异常的独立因素并构建回归模型,评价其预测价值;记录胎儿结局。结果8胎染色体异常,包括5胎18三体、1胎21三体、1胎染色体微缺失微重复及1胎染色体异位。组间囊肿数目及是否合并其他异常比例差异均有统计学意义(P均<0.05)。将囊肿数目及是否合并其他异常纳入回归方程,后者是预测胎儿染色体异常的独立因素(OR=19.865,P<0.05);该模型预测CPC胎儿染色体异常的曲线下面积为0.892,敏感度为87.50%,特异度为78.85%。异常组6胎接受引产,1胎早产、1胎足月顺产,出生后生长发育未见明显异常。正常组5胎接受引产或流产;99胎活产,出生前93胎囊肿消失、6胎至出生前囊肿仍存在。99例新生儿中,17例失访(其中5例出生前囊肿仍存在),80例生长发育无明显异常;1例出生后复查囊肿仍存在,1例诊断为孤独症。结论CPC数目及是否合并其他结构异常可用于预测胎儿染色体异常。

多发性硬化和视神经脊髓炎谱系疾病的脉络丛体积变化

目的探讨脉络丛(ChP)体积在多发性硬化(MS)和视神经脊髓炎谱系疾病(NMOSD)中的变化及其临床意义。方法选取110例MS患者(MS组)、110例NMOSD患者(NMOSD组)和130例健康志愿者(HC组)的三维结构像。应用深度学习算法自动分割侧脑室脉络丛,比较三组之间的ChP体积差异。进一步研究脉络丛体积与脑白质高信号体积及临床指标的相关性。结果MS组和NMOSD组患者的标准化ChP体积较HC组显著增大,MS的ChP体积比NMOSD患者显著增大。两组患者标准化ChP体积均与脑白质高信号的体积明显相关,与临床残疾状态量表(EDSS)相关。MS患者增大的ChP体积与符号数字转换测验(SDMT)评分相关,NMOSD患者增大的ChP体积与同步听觉连续加法测验(PASAT)评分相关。结论MS和NMOSD均显示为侧脑室的ChP体积增大,而两种疾病脉络丛增大的程度不同,MS更为显著。ChP体积与临床躯体残疾及认知损害相关,有望作为评估神经炎性疾病的潜在MRI标记物。

神经内镜第三脑室底造瘘术联合脉络丛烧灼术治疗儿童脑积水的疗效分析

目的 分析神经内镜第三脑室底造瘘术(ETV)联合脉络丛烧灼术(CPC)治疗儿童脑积水的临床治疗效果。方法 回顾性分析2016年1月—2019年1月广东三九脑科医院神经外科收治的50例脑积水患儿的临床资料,依治疗方式不同分为观察组(n=26,ETV联合CPC)和对照组(n=24,ETV)。分析两组患儿治疗效果情况。结果 观察组患儿在总有效率为96.1%,对照组患儿在总有效率为70.8%,两组比较有统计学意义(P<0.05)。其中观察组中因梗阻性脑积水行联合治疗其有效率为100%,因交通性脑积水性联合治疗其有效率为90%,两者对比无统计学意义(P>0.05);对照组中因梗阻性脑积水行联合治疗其有效率为84.6%,因交通性脑积水性联合治疗其有效率为27.3%,两者对比无统计学意义(P>0.05)。观察组1例、对照组7例造瘘术后无效,后转为行脑室腹腔分流治疗。观察组出现1例硬膜下积液,1例气颅(2/26,7.7%),对照组1例癫痫、1例感染(2/24,8.3%),两组的并发症比较无统计学意义(P>0.05);观察组患儿术后半年的平均Gesell发育商数均高于对照组,有统计学意义(P<0.05)。结论 神经内镜下第三脑室底造瘘术联合脉络丛烧灼术治疗儿童脑积水安全有效,显著改善患儿神经发育水平。