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首页> 外文期刊>British journal of neurosurgery >Long term neuropsychological outcome and management of 'decompensated' longstanding overt ventriculomegaly in adults
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Long term neuropsychological outcome and management of 'decompensated' longstanding overt ventriculomegaly in adults

机译：成年人的长期神经心理学结果和“失代偿性”长期显性心室扩大的管理

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Objective. We aimed to study a group of patients presenting with symptomatic longstanding overt ventriculomegaly in adults (LOVA) requiring treatment (endoscopic third ventriculostomy), and to study their long term neuropsychological status and functionality. Methods. Twenty patients were treated with endoscopic third ventriculostomy on presentation and were studied with neuropsychological assessments including the repeatable battery for the assessment of neuropsychological status and the hospital anxiety and depression scores. Pre-and post-operative MRI studies were used to assess the patency of the endoscopic third ventriculostomy (ETV) along with clinical outcome scores. Results. A variety of presenting symptoms were experienced including headache (90%), worsening imbalance, attacks of loss of consciousness and cognitive decline. Mean age of patients was 52 years (range, 1778) with mean head circumference of 60.9 cm. ETV was successful in controlling symptoms in 89% of patients with three patients requiring shunts (gravitational valves). There were no subdurals after surgery. All patients did universally badly in all aspects of the neuropsychological studies without showing any undue anxiety or depression. Conclusion. LOVA patients can decompensate at any time in their adult life with acute symptoms, which are generally well controlled with ETV and with few complications. Sadly, the long-term effects of carrying 'asymptomatic' or compensated hydrocephalus since childhood are of a significant cognitive cost to these patients.
机译：目的。我们的目的是研究一组有症状的成年人长期存在明显的脑室扩大症（LOVA），需要治疗（内镜第三脑室造口术），并研究他们的长期神经心理状态和功能。方法。 20例患者在就诊时接受了内窥镜第三脑室造口术治疗，并接受了神经心理学评估，包括可重复使用的电池评估神经心理学状态以及医院焦虑和抑郁评分。术前和术后MRI研究用于评估内镜第三脑室造口术（ETV）的通畅性以及临床结果评分。结果。出现了各种症状，包括头痛（90％），失衡加剧，意识丧失发作和认知能力下降。患者的平均年龄为52岁（范围1778），平均头围为60.9 cm。 ETV成功地控制了89％的患者的症状，其中三名患者需要分流（重力瓣膜）。手术后没有硬膜下。所有患者在神经心理学研究的各个方面普遍表现不佳，而没有表现出任何不适当的焦虑或沮丧。结论。 LOVA患者可以在成年后的任何时候出现急性症状的失代偿，这些症状通常可以通过ETV很好地控制并且几乎没有并发症。可悲的是，自童年以来长期携带“无症状”或代偿性脑积水的长期影响对这些患者而言是巨大的认知成本。

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