Cerebrospinal Fluid Research

Background At least 75–85% of children born with Spina Bifida (SB) are expected to reach their early adult years. The growing adult SB population encounters a variety of complications including neurological, neurosurgical, cognitive, psychosocial, renal/urological, bowel management, mobility, musculoskeletal/orthopedic, sexual function, skin, and others. Materials and methods We compared two cohorts of adult patients with the diagnosis of Myelomeningocele, Meningocele, and Sacral anomalies associated with Meningocele, regularly controlled in our multidisciplinary SB Unit and treated in two different therapeutical periods. The first series included patients born before 1974 whereas the patients in the second series were born between 1982 and 1989. We collected the data from the medical history, radiographic records and also performed an interview with each patient included in this study. We collected information concerning two aspects: medical and social variables. The medical data included diagnosis, functional neurological level, shunted hydrocephalus, vertebral malformations, intelligence quotient (IQ), urological and faecal incontinence, reeducation of incontinence, orthosis and type of gait. The social data included level of education, employment, marital status and driving licence. We developed a questionnaire with 15 secondary conditions associated with SB which had to be filled in order of importance by all patients with normal or borderline IQ as per Wechsler Scale. Results A total of 206 patients were included in this study: 104 patients in the first series and 102 in the second one. Both series were homogeneous in relation to gender, functional neurological level and diagnosis. We found differences statistically significant in both series in relation to shunted hydrocephalus (p=0.001), spinal deformity (p=0.043), urinary re-education and collection method (p= 0.000), faecal re-education method (p=0.000), gait orthosis (p= 0.045), and educational level (p=0.000) reflecting an improvement in the second series. We found no differences in both series in relation to IQ, incontinence, ambulation, work incorporation, marital status and driving license. Regarding the personal questionnaire, there were statistically significant differences in the perception of both samples in relation to pressure ulcers (p=0.022), urinary incontinence (p=0.001), faecal incontinence (p=0.014), urinary infection (p=0.019), IQ (p=0.012), and sexual activity (p=0.000). Conclusions Management of the musculoskeletal, bowel, bladder, renal, neurological systems, and other issues in SB patients have changed and improved in the last years, regarding not only diagnostic and therapeutic procedures but also a coordinated interdisciplinary team approach that has lead these patients to reach adulthood in better conditions.

Susana Rodriguez

Esther Pages

Ampar Cuxart

Jordi Iborra

Mar Melendez

Judith Sanchez-Raya

Functional results in young adults with spina bifida. A comparative study among two therapeutic periods

年轻脊柱裂成年人的功能结果：两个治疗期之间的比较研究

Background The radiological changes that appear in the corpus callosum in patients with obstructive hydrocephalus, after treatment with a ventricle-peritoneal drainage, are a quite frequent finding in relation with the different series published with no clinical significance. The signal alteration showed by the magnetic resonance (MR) in this brain structure is associated with psychiatric diseases (bipolar disorder, schizophrenia, etc) without knowledge of physiopathological details. We present a case report of a patient with obstructive hydrocephalus who develops important psychiatric symptoms after being treated with a ventricle-peritoneal valve, with the radiological changes described above.

Liberto Brage-Martin

Agustin Castañeyra-Perdomo

Juan C Ribas-Neijerk

Mario García-Conde

Pablo Febles-Garcia

Mario Spreafico-Guerrero

Luis Pérez-Orribo

Rebeca Pérez-Alfayate

Emilia M Carmona-Calero

Victor García-Marín

Manic episode after treatment with ventriculoperitoneal shunting due to obstructive hydrocephalus with corpus callosal signal changes: a case report

脑室腹腔分流术后因阻塞性脑积水伴胼胝体信号改变引起的躁狂发作：一例报告

Results It was agreed that there would be two definitions as seen in all dictionaries. One would be for general use (1) and the second would be for those involved in pathophysiologic studies (2). Definition 1. Hydrocephalus is a dynamic imbalance between the formation and absorption of cerebrospinal fluid resulting in an excessive accumulation of the CSF within the ventricles of the brain. Definition 2 Hydrocephalus is “a dynamic imbalance between the formation and absorption of cerebrospinal fluid resulting in accumulation of excess CSF associated with ventricular dilatation and/or enlargement of the subarachnoid space. The classification would be based on the presence or absence of a point of obstruction and if there is a point of obstruction where that obstruction is located. The various types of hydrocephalus could then be modified by subclassification as to chronicity and as to treatment options. Conclusions Use of a new classification scheme is essential since the latest classification dates to 1914. Use of a classification based on a point of obstruction will lead to a common language among clinicians and researchers which has been absent generally and assure that animal models used in the laboratory can be compared to appropriate clinical conditions.

Harold L Rekate

Definition and classification of hydrocephalus

脑积水定义与分类

The three groups were significantly different (p<0.0001) in Evan’s ratios with HCPM rats (Mean+/-STD = 0.38 +/-0.07, Range: 0.31-0.48) slightly higher than controls (Mean+/-STD = 0.29+/-0.01, Range: 0.27-0.31, p=0.02) but lower than the HCPS group (Mean+/-STD=0.85 +/-0.04, Range=0.80-0.90, p<0.0001). Both FA and MD values were significantly different among the three groups in cortex, corpus callosum and internal capsule (ANOVA, p<0.05). Post-hoc comparisons showed that the HCPM group was not significantly different from the control group, while the HCPS group was significantly different (lower FA and higher MD, p<0.05) from the control group (with the exception of FA in the internal capsule) and the HCPM group. In the HCPM group, it was found that the MD values in the external capsule increased proportionally with ventricle size (R=0.94, p=0.016), while FA values in the internal capsule decreased with increasing ventricle size (R=-0.98, p=0.005). Conclusions Although the DTI measurements in the HCPM rats with mild ventriculomegaly were not significantly different from normal controls, the correlation between ventricle size and DTI values in this group suggested that different levels of abnormality in brain tissues can be detected with DTI during various stages of hydrocephalus. Our results demonstrate that DTI is potentially a sensitive biomarker for monitoring the progression of ventricle enlargement and may help to determine the optimal window for surgical intervention.

Weihong Yuan

James P McAllister

Kelley Deren

Francesco Mangano

Comparison of mild and severe forms of hydrocephalus using diffusion tensor imaging in neonatal rats

利用弥散张量成像对新生大鼠轻度和重度脑积水进行比较研究

Background Associated neurospinal dysraphism in combination with anomalies of the genitourinary tract is well known in children with imperforate anus. There is a broad spectrum of concomittant anomalies with the OEIS Syndrome as the most serious endpoint. OEIS is an acronym for omphalocele, exstrophy (bladder exstrophy/cloacal exstrophy), imperforate anus and spinal defects. At present almost all cases of OEIS are diagnosed prenatally and the patients should be treated at a specialized center with a multidisciplinary team. The complex diagnostic procedures and surgical measures are addressed as well as the difficulties in achieving continence in these patients. Materials and methods We present data of six patients with imperforate anus and spinal dysraphism (4 with meningomyelocele, two with lipomeningocele) currently managed in the spina bifida clinic of the Children’s Hospital of Cologne. Two of them presenting the complete OEIS syndrome symptoms, another two with cloacal exstrophy without omphalocele and two with major renal malformations. Only two of six patients had hydrocephalus. Results

Cora Städtler

Reinhold Cremer

Maximilian W Kellner

Thomas M Boemers

Spinal dysraphism associated with OEIS complex: aspects of diagnosis and treatment

脊髓闭合不全伴OEIS复合体：诊断与治疗方面

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2004，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Journal Fees	$Details
Average review cycle	网友分享经验：14 Weeks

Cerebrospinal Fluid Research

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Functional results in young adults with spina bifida. A comparative study among two therapeutic periods

Manic episode after treatment with ventriculoperitoneal shunting due to obstructive hydrocephalus with corpus callosal signal changes: a case report

Definition and classification of hydrocephalus

Comparison of mild and severe forms of hydrocephalus using diffusion tensor imaging in neonatal rats

Spinal dysraphism associated with OEIS complex: aspects of diagnosis and treatment

Functional results in young adults with spina bifida. A comparative study among two therapeutic periods

Manic episode after treatment with ventriculoperitoneal shunting due to obstructive hydrocephalus with corpus callosal signal changes: a case report

Definition and classification of hydrocephalus

Comparison of mild and severe forms of hydrocephalus using diffusion tensor imaging in neonatal rats

Spinal dysraphism associated with OEIS complex: aspects of diagnosis and treatment