Congenital Hydrocephalus ・ Unsolved Clinical Problems

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  • YAMASAKI Asami
    Department of Neurosurgery, National Hospital Organization, Osaka National Hospital

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  • 先天性水頭症の診療 : 未解決の問題点

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Problems of fetal hydrocephalus and adult patients with congenital hydrocephalus continue to be unsolved. Recently 55% of congenital hydrocephalus is diagnosed prenatally as fetal ventriculomegaly, as result of advances in prenatal imaging techniques. The result of the nation-wide survey performed in 1999 shows that fetal ventriclomegaly include various disorders, such as simple hydrocephalus, myelomeningocele (MMC), Dandy-Walker syndrome, holoprosencephaly, encephalocele. The survey showed a wide variation of outcome, with normal outcome 19%, slightly delayed 22%, moderately delayed 25%, severely delayed 28.5% and peri and postnatal death 5.5%. This variation seems to be determined by the basic disease and associated anomaly. A guideline for the diagnosis and treatment of fetal hydrocephalus is urgently required, which should be based on the analysis of the clinical data on each disorders and critical appraisal of reviews. Adult patients with congenital hydrocephalus are now increasing. The new issue on medical and social problems surrounding adult patients with congenital hydrocephalus should be discussed.

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