小头畸形的消退是胎儿枕部颅脑手术中神经心理运动发育的保护因素。

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Child's Nervous System Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI:10.1007/s00381-024-06597-0
Jardel Mendonça Nicácio, Sergio Cavalheiro, Marcos Devanir Silva da Costa, Patricia Alessandra Dastoli, Italo Capraro Suriano, Mauricio Mendes Barbosa, Stéphanno Gomes Pereira Sarmento, Tereza Cristina Carbonari de Faria, Antonio Fernandes Moron
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引用次数: 0

摘要

目的:脑畸形是一种神经管闭合缺陷,其特点是颅内内容物通过颅骨疝出,死亡率高达 33.3%。存活的患者中约有 50%存在一定程度的神经运动发育障碍或癫痫发作。本研究旨在分析接受胎儿枕部颅脑畸形矫正术的患者神经心理运动发育良好(NPMD)与小头畸形逆转之间的关系,并将这些结果与产后手术患者的结果进行比较:22名参与者分为两组:胎儿组(FG)10人,产后组(PNG)12人。在研究过程中,1 名患者被排除在 FG 组之外,2 名患者被排除在 PNG 组之外,共计 19 名患者参与了研究。2012年7月至2018年7月期间,所有患者均由同一医疗服务机构进行诊断、评估和监测。所有参与者均接受了仔细的发育评估,评估使用的是贝利婴儿发育量表第二版(BSID-II),评估年龄为 2 岁 11 个月。此外,他们还在出生后第一年进行了CP测量,以监测他们的发育情况。研究了小头畸形逆转与非畸形儿之间的关系:结果:按胎龄调整后的CP显示,在矫正FG中的脑畸形后,渐进性小头畸形有逆转的趋势。我们发现,PNG 和 FG 的 BSID-II 中位数得分在统计学上存在显著差异。FG患者在出生后第一年的CP发育保持正常,而PNG患者仍为小头畸形:结论:FG 患儿小头畸形的逆转直接影响到良好的新生儿疾病,可被视为一种保护因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Regression of microcephaly as a protective factor of neuropsychomotor development in fetal surgery for occipital encephalocele.

Purpose: Encephaloceles are neural tube closure defects characterized by herniation of intracranial contents through the skull, with a mortality rate of 33.3%. Approximately 50% of patients who survived have some degree of neuropsychomotor developmental impairment or seizures. This study aimed to analyze the relationship between good neuropsychomotor development (NPMD) in patients undergoing fetal occipital encephalocele correction and the reversal of microcephaly, comparing these outcomes with those observed in patients who underwent postnatal surgery.

Methods: The 22 participants were categorized into two groups: 10 in the fetal group (FG) and 12 in the postnatal group (PNG). During the study, 1 patient was excluded from the FG and 2 patients were excluded from the PNG, totaling 19 patients in the study. All patients were diagnosed, evaluated, and monitored by the same healthcare service between July 2012 and July 2018. All participants were subjected to a careful developmental assessment using the Bayley Scale of Infant Development, Second Edition (BSID-II), up to 2 years and 11 months of age. Additionally, CP measurements were taken during the first year of life to monitor their progress. The relationship between microcephaly reversal and NPMD was studied.

Results: The CP adjusted for gestational age showed a tendency toward the reversal of progressive microcephaly after correction of encephaloceles in the FG. We found a statistically significant difference in the median BSID-II score between the PNG and FG. Patients in the FG maintained normal CP development in the first year of life, whereas those in the PNG remained microcephalic.

Conclusion: The reversal of microcephaly in the FG directly influences good NPMD and can be considered a protective factor.

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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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