莫亚莫亚病的术后认知结果:一个系统性审查
Devon L Mitchell1, Nathan A Shlobin1, Melissa A LoPresti1
1Division of Pediatric Neurosurgery, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Lurie Children's Hospital, Chicago, Illinois, USA.
World neurosurgery
|July 28, 2023
概括
重血管化手术改善了儿科莫亚莫亚病 (MMD) 患者的认知结果,但许多人仍然经历了损伤. 诸如性别,手术时的年龄和之前的中风等因素会影响认知结果.
科学领域:
- 神经学 神经学
- 儿科神经外科 儿科神经外科
- 认知神经科学 认知神经科学
背景情况:
- 莫亚莫亚病 (MMD) 是一种进展性脑血管封闭性疾病,导致儿童中风.
- 重血管化手术是MMD的主要治疗方法,但其对儿科认知功能的影响尚不清楚.
- 现有的研究主要集中在临床和放射性结果,留下关于干预后认知变化的知识差距.
研究的目的:
- 系统地审查和分析患有莫亚莫亚病的儿科患者的术后认知结果.
- 确定MMD儿童在重血管化手术后与认知变化相关的因素.
- 确定重血管化手术对儿科莫亚莫亚病患者认知表现的具体影响.
主要方法:
- 按照PRISMA指南进行了系统的文献审查.
- 在PubMed,Embase和Scopus数据库中对相关研究进行了搜索.
- 纳入标准集中在患有MMD的儿科患者,接受了重血管化手术,并报告认知结果 (定性或定量).
主要成果:
- 在1091篇文章中,包括12项涉及446名患者的研究在分析中.
- 再血管化手术与保持或改善智商 (IQ) 和记忆功能有关.
- 尽管整体情况有所改善,但70%的患者表现出认知障碍,学校表现不佳. 诸如大脑血流增加,女性性别,症状到手术的时间缩短以及7岁后的手术等因素预测了更好的结果,而之前的中风预测了更差的结果.
结论:
- 儿科莫亚莫亚病患者在重血管化手术后通常表现出改善的认知功能.
- 许多患有MMD的儿童在手术后经历了持续的认知障碍.
- 个体患者因素和与治疗相关的变量对于风险分层和优化儿科莫亚莫亚病的管理策略至关重要.
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