Neurocognitive outcome after endoscopic third ventriculocisterostomy in patients with obstructive hydrocephalus.
Neurocognitive outcome after endoscopic third ventriculocisterostomy in patients with obstructive hydrocephalus.
复制标题
梗阻性脑积水患者内镜下第三脑室造口术后的神经认知结果。
DOI：
10.1017/s1355617709090560
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Frim,MDavid
中科院分区：
文献类型：
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作者：
Lacy,Maureen;Oliveira,Martin;Austria,Emily;Frim,MDavid
阻塞性脑积水可以通过颅外分流系统治疗，或者当阻塞位于第三脑室后部和第四脑室流出道之间时，可以通过内窥镜第三脑室胸腔造口术（ETV）治疗。颅外分流装置的放置会带来巨大的长期感染和故障风险。这种风险催生了 ETV 优于分流的概念。虽然分流脑积水患者的长期认知表现已得到广泛检查，但对接受 ETV 患者的结果的研究却很少。经机构审查委员会批准，10 名接受过 ETV 的成年人进入了这项研究。每个患者都接受了一系列神经心理学测试，包括基本注意力、言语记忆、视觉记忆、语言和执行功能等领域的测试。与规范数据相比，总体测试分数显示记忆和执行功能领域的表现有所下降。本研究揭示了 ETV 干预后患者的记忆和执行领域持续认知低效。考虑先前分流、头痛、情绪状态和手术并发症的影响的更大规模的纵向研究将有助于阐明这些缺陷的病因和最终治疗。 (JINS, 2009, 15, 394–398.)
Obstructive hydrocephalus can be treated with an extracranial shunting system or, when the obstruction is between the posterior third ventricle and the fourth ventricular outflow tracts, by an endoscopic third ventriculocisternostomy (ETV). The placement of an extracranial shunting device entails significant long-term risk of infection and malfunction. This risk has led to the concept that ETV is preferable to shunting. While the long-term cognitive performance of shunted hydrocephalus patients has been extensively examined, the outcome of patients undergoing ETV has been studied only sparsely. Ten adults who had undergone ETV were entered into the study under institutional review board approval. Each patient underwent a neuropsychological testing battery that included testing within the domains of basic attention, verbal memory, visual memory, language, and executive functioning. Aggregate test scores showed a decrease in performance in the domains of memory and executive functioning when compared to normative data. The present study revealed persistent cognitive inefficiencies in memory and executive domains in patients post-ETV intervention. A larger longitudinal study considering the impact of prior shunting, presence of headaches, emotional status, and surgical complications will assist in elucidating the etiology and eventual treatment of these deficits. (JINS, 2009, 15, 394–398.)