NATURAL HISTORY OF HYDROCEPHALUS - DETAILED ANALYSIS OF 182 UNOPERATED CASES
NATURAL HISTORY OF HYDROCEPHALUS - DETAILED ANALYSIS OF 182 UNOPERATED CASES
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DOI：
10.1136/adc.37.194.345
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发表时间：
1962-01-01
影响因子：
5.2
通讯作者：
COATES, S
中科院分区：
文献类型：
--
作者：
LAURENCE, KM;COATES, S
对20年来由一名外科医生诊治的182例未手术的脑积水病例进行了随访。其中81例（46%）脑积水自发停止，9例仍在进行，89例（49%）死亡。三人下落不明，但被认为还活着。该系列代表了3个月后社区中的疾病，幸存者进入成年生活的预期寿命（精算）为26%。发病年龄取决于疾病的病因[长破折号]，自然停搏发生在9个月至2岁半之间，但患者仍有风险。在被捕的幸存者中，73%是可教育的（I。Q. 38%的人智商在正常范围内（超过85）。39名患者中几乎没有身体残疾，只有11名患者视力严重缺陷或失明。智力、头部大小、皮质厚度和疾病进展时间之间无相关性。智力与身体残疾之间存在高度负相关，两者均不随年龄增长而改善。许多儿童表现出典型的脑损伤特征，这被认为是由于最初的脑损伤而不是皮质变薄。情绪波动相对较少。它的结论是，手术应进行迅速进行性脑积水，以防止进一步的脑损伤，但必须谨慎逮捕或逮捕的情况下行使。
Over a 20-year period 182 unoperated cases of hydrocephalus seen by one surgeon were followed up. Of these 81 cases (46%) were found to be alive with the hydrocephalus arrested spontaneously, 9 remained progressive and 89 (49%) had died. Three remained untraced but were presumed alive. The series is representative of the disease in the community after the age of 3 months, and the life expectancy (actuarial) of the survivors into adult life is 26%. The age of onset is dependent upon the aetiology of the condition[long dash]the natural arrest occurs between 9 months and 2 1/2 years, but the patients remain at risk. Of the arrested survivors 73% were educable (I. Q. more than 50) and 38% had I.Q.s within the normal range (more than 85). Little or no physical handicap was seen in the 39 patients and only 11 had severely defective vision or were blind. No correlation was found between intelligence, head size, cortical thickness and duration of progressive disease. A high negative correlation existed between intelligence and physical disability, and neither improved with age. Many of the children show the classical features of brain damage which is thought to be due more to the original brain insult than to cortical thinning. Emotional disturbances were relatively few. It is concluded that surgery should be undertaken in rapidly progressive hydrocephalus in order to prevent further brain damage, but caution must be exercised in arresting or arrested cases.