The effects of multiple shunt revisions on neuropsychological functioning and memory

Ralph, Kathryn J.; Moylan, Patricia M.; Canady, Alexa; Simmons, Sabrina

doi:10.1080/01616412.2000.11741049

Cited by 28 publications

(13 citation statements)

References 8 publications

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“…This finding was consistent with previous studies reporting no decreases in IQ scores with an increase in the number of shunt revisions in children with hydrocephalus. 31 Contrary to the third hypothesis, the occurrence of multiple shunt revisions was associated with decreased FA and smaller ventricular volume (with the exception of those who had undergone ≥ 5 shunt revisions who displayed higher FA along frontal pathways than participants who had undergone 2-4 revisions).…”

mentioning

confidence: 51%

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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OBJECT No previous reports exist that have evaluated the relationships of white matter (WM) integrity with the number of shunt revisions, ventricular volume after shunting, and cognition in medically stable children who have spina bifida and hydrocephalus (SBH). The authors hypothesized that enlarged ventricles and a greater number of shunt revisions decrease WM integrity in children. METHODS In total, 80 children (mean age 13.7 years) who had SBH underwent MRI and IQ testing. Probabilistic diffusion tractography was performed to determine mean diffusion tensor imaging (DTI) metrics along the frontal and parietal tectocortical pathways. The DTI metrics were evaluated for significant correlation with a composite IQ measure and with the total number of shunt revisions and the total lateral ventricular volume obtained through semiautomated parcellation of T1-weighted MRI scans. RESULTS An enlargement in total lateral ventricle volume and an increase in the number of shunt revisions were both associated with higher fractional anisotropy (FA) and with lower radial diffusivity (RD) along both frontal and parietal tectocortical pathways. Children who had not undergone a shunt revision had on average a greater lateral ventricle volume and higher FA and lower RD along frontal and parietal pathways than those who had undergone multiple shunt revisions. The mean DTI metrics along parietal pathways predicted IQ scores, but intellectual ability was not significantly correlated with ventricular volume or with the number of lifetime shunt revisions. CONCLUSIONS Significant changes in DTI metrics were observed as a function of ventricular volume. An increased lateral ventricle volume was associated with elevated FA and decreased RD. Given that the participants were medically stable at the time of the MRI examination, the results suggested that those who have enlarged ventricles show a DTI pattern consistent with axonal compression due to increased intracranial pressure (ICP) in attenuated hydrocephalus. Although limited by a cross-sectional design, the study's findings suggest that DTI metrics may serve as sensitive indicators for chronic, mild hydrocephalus in the absence of overt clinical symptoms due to increased ICP. Having enlarged ventricles and undergoing multiple shunt revisions did not affect intellectual ability in children with SBH.

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confidence: 51%

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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“…Significant verbal and non-verbal memory deficits have been reported in children with both MMC and infantile hydrocephalus (Vachha & Adams 2005;Ralph et al, 2000;Scott et al, 1998;Yeates & Enrile, 2005). This study revealed that children with hydrocephalus had significant difficulty recalling short stories, both immediately and after 30 minutes.…”

Section: The Impact Of Hydrocephalus On Cognition and Neuropsychologimentioning

confidence: 65%

Behavioural problems and autism in children with hydrocephalus

Lindquist

Carlsson

Persson

et al. 2006

Eur Child Adolesc Psychiatry

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Aims: The main objective of this thesis was to explore the cognitive and behavioural consequences of hydrocephalus in children born at term and preterm, with or without myelomeningocele (MMC) and with or without concomitant neurological impairments, such as cerebral palsy (CP), epilepsy or learning disabilities. Material and methods:From a population-based cohort of all 107 children with hydrocephalus born in [1989][1990][1991][1992][1993] 73 of the surviving children were assessed with intelligence tests and most of them also using behavioural and autism rating scales. Thirty-six of 47 (77%) children with an IQ of ≥ 70 and eight children with MMC but no hydrocephalus were assessed with a neuropsychological test battery (NIMES) and compared with age-and gender-matched controls. Results:One-third of the children were normally gifted (IQ > 85), another 30% had a low-average IQ of 70-84 and 37% had learning disabilities (IQ < 70). An IQ of < 70 was found in 42% of children without MMC and in 29% of those with MMC. Children born preterm had a lower IQ than those born at term. Children with CP and/or epilepsy had significantly lower IQ scores than those without these impairments. Parents rated 67% and teachers 39% of the children as having behavioural problems. Learning disabilities increased the risk significantly. Almost all the children with CP and/or epilepsy had behavioural problems. Learning disabilities, CP and epilepsy significantly increased the risk of autistic symptoms, which were present in 13 %, in 4 % of those with MMC and in 20 % of those without MMC. Children with hydrocephalus both with and without MMC and with an IQ of > 70 performed significantly less well than controls on learning, memory and executive functions but not on registration skills. There were no differences between children with hydrocephalus in combination with MMC and those without MMC, whereas children with MMC but no hydrocephalus and normal intelligence performed as well as controls on all the neuropsychological functions. Conclusions:The majority of children with hydrocephalus had learning disabilities or a low-average IQ, as well as behavioural problems, and some had autistic symptoms. Despite average or slightly below average intelligence, children with hydrocephalus had major difficulties with learning and memory and with executive functions, regardless of the aetiology of the hydrocephalus. Only MMC did not appear to influence cognitive and neuropsychological outcome as much as the brain lesion causing or caused by the hydrocephalus.

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“…Significant verbal and nonverbal memory deficits have been reported in children with MMC and infantile hydrocephalus (15–17,33). This study revealed that children with hydrocephalus had significant difficulties to recall short stories, both immediately and after 30 min.…”

Section: Discussionmentioning

confidence: 99%