The Long-Term Psychological Effects of Surgical Treatment Using Neuroendoscopic Techniques and Orbis Sigma Shunt Implantation in Children Suffering From Hydrocephalus
Journal Title: Advances in Clinical and Experimental Medicine - Year 2012, Vol 21, Issue 3
Abstract
[b]Background.[/b] Hydrocephalus, which is the most common disease of the central nervous system in children, has a diverse etiology and clinical picture. Children suffering from hydrocephalus are often treated either by using a neuroendoscopic procedure or by Orbis Sigma shunt implantation. [b]Objectives.[/b] To evaluate the long-term psychological effects of neuroendoscopic surgical treatment on the mental development and cognitive abilities of children suffering from hydrocephalus, in comparison with the results following Orbis Sigma shunt implantation, and to assess the impact of the kind of hydrocephalus on the outcome of the treatment. [b]Material and Methods.[/b] The study involved 78 patients treated surgically for chronic noncommunicating hydrocephalus: 39 patients who had undergone neuroendoscopic surgery (average age: 12 years, SD } 7 years), and 39 who had undergone implantation of a ventriculo-peritoneal shunt (average age: 14 years } 5 years). The psychomotor development of the two groups was analyzed using psychomotor development tests including the Brunet- Lezine test, the Terman-Merrill test, Raven’s Standard Progressive Matrices, Raven’s Colored Progressive Matrices, the Benton Visual Retention Test, the Bender Visual Motor Gestalt Test, the Rey Fifteen-Item Memory Test, lateralization tests and a questionnaire. [b]Results.[/b] In the shunt group there were statistically significant prevalences hydrocephalus diagnosed perinatally and in the first year of life (p = 0.0291), epileptic seizures (p = 0.0181), intellectual disability (p = 0.0049) and gait disturbances (p = 0.006). There were statistically significant differences between two groups in the relative changes of linear measurements of the cerebral ventricle depending on the type of treatment: Relative Frontal Horn Index (RFHI): 0.93 following endoscopy and 0.64 following shunt implantation; Relative Evans’ ratio (RER): 0.93 following endoscopy and 0.62 after shunt implantation; Relative Frontal and Occipital Horn Ratio (RFOHR): 0.89 after endoscopy and 0.69 after shunt implantation. The time treatment was undertaken and the incidence of mental retardation did not differ significantly between the two groups. [b]Conclusions. [/b]The analysis of cerebral ventricle enlargement expressed in linear ventricular enlargement measurements revealed statistically important differences in the intellectual, cognitive and motor development between the groups treated with the two neurosurgical techniques.
Authors and Affiliations
Barbara Wiśniewska, Wanda Mikołajczyk-Wieczorek, Bartosz Polis, Lech Polis, Krzysztof Zakrzewski, Emilia Nowosławska
Assessment of Dietary Flavonoid Intake Among 50-year-old Inhabitants of Wroclaw in 2008
[b]Background.[/b] In much epidemiological research, a positive impact of flavonoid intake on human health has been observed. The role of flavonoids in heart diseases and cancer prevention was described. [b]Objectives....
Effectiveness and Safety of Topical Emollients in the Treatment of PUVA-Induced Pruritus
<strong>Background</strong>. In this study we tried to assess the efficacy of topical emollients in the treatment of patients with PUVA-induced pruritus.<br /><strong>Material and Methods</strong>. 41 patients over 18 ye...
Second-Trimester IL-15 and IL-18 Levels in the Amniotic Fluid of Fetuses with Normal Karyotypes and with Chromosome Abnormalities
[b]Background.[/b] Little is known about the behavior of interleukin 15 (IL-15) and 18 (IL-18) in the amniotic fluid in the second trimester of gestations complicated by chromosomal defects in the fetus. Likewise, it has...
Lung Hernia – a Review
Lung hernia is a protrusion of lung tissue through one of its bounding structures. This uncommon condition develops most commonly as a result of trauma or after thoracic operations. Other lung hernias, particularly supra...
Results of Specialized Ambulatory Diabetes Care Among Diabetes Patients at the Level of Primary Health Care – in the Light of Nationwide Research
[b]Background.[/b] The availability of health services, understood as the ease of access to a given service or help, is a basic element of the operation of the health care system. In the case of people suffering from dia...