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Síndrome de Dandy-Walker con hidrocefalia ¿tratamiento con VPS o CPS? Un estudio retrospectivo unicéntrico
Zhiqiang Liu1,2, Bei Liu1,2, Chaoqun Weng1,2
1Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China.
Resumen
La derivación ventriculoperitoneal (DVP) puede ofrecer mejores resultados que la derivación cistoperitoneal (DCP) para el tratamiento de la hidrocefalia relacionada con el síndrome de Dandy-Walker (SDW) en niños. El buen desarrollo del vermis cerebeloso está fuertemente relacionado con resultados quirúrgicos positivos.
Área de la Ciencia:
- Neurocirugía Pediátrica; Neurología del Desarrollo; Investigación de Resultados Quirúrgicos
Sus antecedentes:
- El síndrome de Dandy-Walker (SDW) a menudo coexiste con hidrocefalia, lo que requiere intervención quirúrgica.; El abordaje quirúrgico óptimo para la hidrocefalia en el SDW, comparando específicamente la derivación ventriculoperitoneal (DVP) lateral y la derivación cistoperitoneal (DCP) de la fosa craneal posterior, sigue siendo un tema de debate.
Objetivo del estudio:
- Comparar retrospectivamente las características clínicas, la imagen craneal y los resultados de la DVP frente a la DCP en niños con hidrocefalia relacionada con el SDW.; Proporcionar información basada en evidencia para la toma de decisiones quirúrgicas en el manejo de la hidrocefalia asociada al SDW.
Principales métodos:
- Análisis retrospectivo de datos clínicos de 12 pacientes pediátricos con hidrocefalia relacionada con el SDW (malformación o variante de Dandy-Walker).; Los pacientes fueron tratados con DVP (n=8) o DCP (n=4).; Los resultados se evaluaron utilizando el índice de Evans, las escalas de comportamiento adaptativo de Vineland (VABS) y la evaluación del desarrollo de la hidrocefalia y el vermis cerebeloso.
Principales resultados:
- La DVP se asoció con resultados clínicos significativamente mejores, FOHR postoperatorio y puntuaciones VABS en comparación con la DCP (P<0,05).; El buen desarrollo del vermis cerebeloso se correlacionó fuertemente con resultados favorables en ambos grupos quirúrgicos (P=0,018).; Nueve pacientes lograron buenos resultados y tres tuvieron resultados regulares; el grupo de DVP mostró resultados superiores en términos de tamaño ventricular y puntuaciones VABS.
Conclusiones:
- Para la hidrocefalia pediátrica relacionada con el SDW, la DVP puede conducir a resultados clínicos superiores en comparación con la DCP.; El desarrollo adecuado del vermis cerebeloso es un factor crítico que influye en el éxito quirúrgico en estos pacientes.
Palabras clave:
NiñoDerivación cistoperitonealSíndrome de Dandy-WalkerDerivación ventriculoperitonealMás Videos Relacionados
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