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Basic and Clinical Study of Morphological and Functional Changes in Brainstem and Cerebellum in the Cases with Disturbances in Dynamics of Cerebrospinal Fluid Circulation

脑脊液循环动力学障碍患者脑干和小脑形态及功能变化的基础与临床研究

基本信息

批准号：
08457365
负责人：
TAMAKI Norihiko
金额：
$ 3.52万
依托单位：
Kobe University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

项目摘要

Perioperatively intelligence tests were performed in fourteen cases (mean age of 74.8 years) that were diagnosed normal pressure hydrocephalus. Criteria for shunts were, 1) mar than two of trias of NPH, 2) ventriculomegaly, 3) IIIb-V in CTC, 4) rate of B-wave was more than 35% in ICP monitoring, 5) not high risk of operation and general anesthesia. All cases were performed shunts. Surgical results of intelligence tests were good in four cases, fair in four cases, no change in four cases and deteriorated in two cases.CT, MRI, CT cisternography, and cerebral blood flow measurement were analyzed in seven cases (mean age of 66 years) of normal pressure hydrocephaly. V-P shunts were performed in all ases. Postopretave symptoms were improved in five cases. There were tendencies of improvement after sugical treatments in cases which had severe ventriculomegaly, low CBF in periventricular white matter and cortex of frontal lobe, and higher frequency of abnormal waves in ICP monitoring.We performed a retrospective study in 124 patients (mean age of 35.5 years) of hydrocephalus. Forty-five patients were performed only single shunt operations. Forty-nine patients required the revisions of their shunts. The postoperative symtopms were improved in some cases even if they didn't fill the criteria of CTC or ICP monitoring test. Further investigation is required in analyzing clinical symptom with cerebrospinal fluid dynamic test in decision making for shunt operation.

对14例（平均年龄74.8岁）诊断为正常压力脑积水的患者进行围手术期智力测试。分流的标准是，1）NPH三联征超过2个，2）脑室扩大，3）CTC IIIb-V，4）ICP监测中B波率超过35％，5）手术和全身麻醉的风险不高。所有病例均进行分流术。手术智力测试结果良好4例，一般4例，无变化4例，恶化2例。对7例（平均年龄66岁）常压脑积水患者进行CT、MRI、CT脑池造影及脑血流测量分析。在所有病例中均进行了 V-P 分流。 5 例患者术后症状得到改善。脑室扩大严重、脑室周围白质和额叶皮质CBF低、ICP监测异常波频率较高的病例经手术治疗有好转趋势。我们对124例（平均年龄35.5岁）脑积水患者进行了回顾性研究。 45 名患者仅进行了单次分流手术。四十九名患者需要修改分流术。即使不符合CTC或ICP监测测试的标准，部分病例术后症状也有所改善。通过脑脊液动力学试验分析临床症状以做出分流手术的决策还需进一步研究。