[Follow-up of children with early neonatal surgery of fetal hydrocephalus].
This is a retrospective study of patients with surgically treated antenatal diagnosed hydrocephalus. We conducted the study to elucidate the outcomes of the patients, as well as potential pitfalls in their care. A series of 51 patients underwent surgical intervention between 1987 and 1997. All lesions were diagnosed by antenatal ultrasound sonography. After the estimation of their lung maturation, they were delivered in early pregnancy stage and the operation had performed for hydrocephalus. 43 children could be followed-up. To estimate the morphological improvement from radiological examinations objectively, we compared cerebroventricular index (CVI) of pre-operation with that of post-operation. The result was that excellent improvement group was 18 cases, good improvement group was 13 cases, fair improvement group was 8 cases and poor improvement group was 4 cases. In 43 cases, 20 children also had myelomeningocele and in them the improvement of hydrocephalus was that excellent improvement group was 10 cases, good improvement group was 5 cases and fair improvement group was 5 cases. About motor function of 20 children with myelomeningocele, only 5 children were ambulatory with brace. Attending to the rest 23 children without myelomeningocele, 6 children in 8 excellent improvement cases and 6 children in 8 good improvement cases were ambulatory by themselves. But all 7 children belonging to fair and poor improvement groups were unambulatory. We concluded that it was necessary to improve dilated ventricle on the radiological examinations with surgical procedure in order to get better motor function, even semilobar and lobar holoprosencephaly.
Wada
K
K
Department of Neurosurgery, Osaka Medical Center, Japan.
Morimoto
K
K
Takemoto
O
O
Yoshimine
T
T
D002657:Child Development; D002675:Child, Preschool; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal