[IQ in hydrocephalus and myelomeningocele. Implications of surgical treatment].
Myelomeningocele occurs in 0.4 for 1000 neonates and is associated with hydrocephalus in 85-90%, and reports on cognition are sparsely found in literature. Forty five children with treated hydrocephalus and myelomeningocele were studied in regard of IQ, and statistically correlated to functional motor level, age of the first shunt, number of revisions of shunt, infection of the shunt and circumference of the head. The medium age was of 7.5 years (3-15 years), 16 males and 29 females. Three (6.6%) had a IQ score > 110, 11 (24.4%) had a score between 100-110, 8 between 85-100 (17.7%), 16 (35.5%) between 85-100 (17.7%) and 7 (15.5%) between 50-70. IQ directly correlated with motor level, having better cognitive results the children with minor functional motor disabilities. Cognition was best in children operated until the seven day of life (t 0.0099), with progressive worse results in children operated after the first month of life, no significance was observed in children operated in the period 7 to 31 days (t 0.1013). Worse results were observed in the group of patients with infection of shunts (t 0.0146). Results were progressively worse with reoperations. The best results in relation of the circumference of the head were seen with children in the medium range (t 0.0115); intermediate results were seen in patients between the medium range and-1SD (t 0.00130) and medium range and +1SD. The worse results were seen in patients at the extremes of > 1SD (t 0.0269) and < ISD (t 0.0042). According to cognitive results the surgical treatment of hydrocephalus have to be done until the first month of life, avoiding reoperations and infections that have unfavorable impact in IQ.
Fobe
J L
JL
Setor de Neurocirurgia, AACD, São Paulo, Brasil. jeanfobe@yahoo.com
Rizzo
A M
AM
Silva
I M
IM
Da Silva
S P
SP
Teixeira
C E
CE
De Souza
A M
AM
Fernandes
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007360:Intelligence; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D011581:Psychological Tests