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首页> 外文期刊>British journal of neurosurgery >Surgical congenital central nervous system anomalies in a tropical teaching hospital
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Surgical congenital central nervous system anomalies in a tropical teaching hospital

机译：热带教学医院的外科先天性中枢神经系统异常

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Background. Surgical congenital malformations of the central nervous system (CNS) are structural defects with potential for morbidity and mortality more so if intervention is delayed. Aim. To determine the frequency and pattern of surgical CNS anomalies in our region. Methods. We carried out a hospital-based prospective observational study of all consecutive children who presented to our unit over a 2-year period. Brain computerised tomography and/or magnetic resonance imaging was performed on all patients suspected of having cranial CNS abnormalities. Results. There were 94 children with surgical congenital anomalies of the CNS during the study period, with a male to female ratio of 1:1.1. There was no parental consanguinity in all the cases neither were there any history of preconception use of folic acid in all the mothers of the patients. Prenatal ultrasound was done after the first trimester in 91 cases (97%), but anomaly was noted in only 23 cases (25.3%). Eighty-six percent of the patients presented after the first month of life. Though there was a general delay in presentation, patients with neural tube defect tended to present much earlier compared to others (p 0.005). Likewise, patients with spinal anomalies tend to be seen much earlier. Conclusions. Late presentation of CNS anomalies is still the norm in our region. The result makes a case for an aggressive approach to periconceptional folic acid supplementation for our women and policy to encourage fortification of a staple food with folic acid. A nationwide effort to fully clarify the epidemiology is needed so as to indicate where the community and governmental resources, including educational efforts should be directed.
机译：背景。中枢神经系统（CNS）的外科先天性畸形是结构性缺陷，有潜在的发病率和死亡率，因此，如果延迟干预，则更是如此。目标。确定我们区域外科中枢神经系统异常的频率和模式。方法。我们对所有在两年内就诊的连续儿童进行了一项基于医院的前瞻性观察研究。对所有怀疑患有颅神经中枢神经系统异常的患者进行了脑部计算机断层扫描和/或磁共振成像。结果。在研究期间，有94名患有中枢神经系统手术先天性异常的儿童，男女比例为1：1.1。在所有病例中，没有父母亲的血缘关系，在所有患者的母亲中，也没有任何怀孕前使用叶酸的病史。头三个月后进行了产前超声检查，其中91例（97％），但只有23例（25.3％）出现异常。生命的第一个月后出现的患者有86％。尽管一般出现延迟，但神经管缺损患者的出现时间要比其他患者早得多（p 0.005）。同样，脊柱异常患者往往更早就诊。结论中枢神经系统异常的迟发表现仍是我们地区的常态。结果为我们的妇女采取积极的方法进行孕周叶酸补充提供了依据，并提出了鼓励用叶酸强化主食的政策。需要在全国范围内充分阐明流行病学的努力，以便指出应将社区和政府资源（包括教育工作）指向何处。

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