兒童水腦症患者之預後及學習能力：初步報告

This study is to determine the prognosis and academic performance in hydrocephalic children with different etiologies. We reviewed the medical records of all the patients who had the diagnoses of hydrocephalus and had been regularly followed between 1983 and 1997. The patients were categorized into six different etiological groups as 1. premature type hydrocephalus, 2. idiopathic hydrocephalus, 3. hydrocephalus occurring after meningitis, 4. hydrocephalus associated with congenital anomalies, 5. hydrocephalus associated with myelomeningocele and 6. hydrocephalus not receiving any surgery. The ages at first shunt insertions, shunt revision rates, causes of shunt revisions, percentage of physical and mental handicap and intelligence test results were discussed. After a mean of 5.48 years of follow up in 67 patients, the group of hydrocephalus associated with myelomeningocele had the lowest first shunting age; hydrocephalus occurring after meningitis had significantly the highest revision rate and the lowest intelligence test scores. Sixty-four percent of those who answered the questionnaires went to normal schools and among them, 32% had excellent scores. Twenty percent of these patients required special forms of education and 7.7% could not receive any forms of education due to severe disabilities. This report reviewed the criteria of surgical interventions and discussed the outcome of different types of hydrocephalic patients, which is highly valuable in family counseling.