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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 13 (1997), S. 546-549 
    ISSN: 1433-0350
    Keywords: Key words Cerebrospinal fluid shunt ; Hydrocephalus ; Immunoglobulin ; Infant ; Infection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebrospinal fluid shunt infection is serious and one of the most frequent complications of shunt implantation. Age has been one of the most significant host factors for the development of shunt infections. A relative deficiency of the immune response against bacteria in infants could partly explain the higher infection rate in the very young patients. This prospective-randomized study was conducted in two groups: group A (immunoglobulin group) and group B (control group). There were 30 patients in each group. The patients in group A received intravenous immunoglobulin (Sandoglobulin®) at a dose of 1 g/kg in the night before surgery. Each patient was followed up to 6 months. No infection was seen in group A. In group B, infection rate per procedure and infection rate per patient were 5.1% (P=0.494) and 6.6% (P=0.492), respectively. Intravenous immunoglobulin prophylaxis in infants seems to reduce the shunt infections.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 14 (1998), S. 120-123 
    ISSN: 1433-0350
    Keywords: Key words Congenital malformation ; Infant ; Meningomyelocele ; Neural tube defect ; Newborn ; Spinal cord
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The medical records of 190 patients with meningomyelocele operated on between 1979 and 1993 were reviewed. In 65 patients, psychometric tests were performed. The Denver Developmental Screening Test and the Wechsler Intelligence Scale for Children, Revised (WISC-R) were used in children under and over 6 years old, respectively. There were 82 boys (43.2%) and 108 girls (56.8%). The lumbar region was the site of the meningomyelocele in 113 patients (59.5%). Patients with cervical and sacral meningomyelocele had a higher rate of almost normal motor function than those with meningomyelocele at other levels (P=0.000). Only 36 (21.7%) of 166 patients followed up by us did not have hydrocephalus. We also noted that the higher the location of the meningomyelocele, the greater the control of both sphincters (P=0.014). Fifty-four percent of the hydrocephalic patients had a normal development or IQ. Psychometric tests were normal in 76% of those without hydrocephalus. Twenty-four patients were lost to follow-up. The follow-up of the remaining 166 patients ranged from 1 month to 180 months (mean 60.2 months). Fifty-three patients (32%) died, central nervous system infection being the most common cause of death (44%). The management of children with meningomyelocele needs a team approach.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-0350
    Keywords: Key words Continuous external subdural drainage ; Infant ; Subdural hematoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Continuous external subdural drainage (CESD) was suggested as a treatment step to be inserted prior to SP shunting, primarily because it makes it possible to avoid shunt placement in a significant number of patients. Thirty-three patients with symptomatic chronic subdural collection confirmed by computed tomography were included in this study. Unilateral CESD was performed in all cases, using a lumbar drainage set. The drains were left in place for no more than 10 days. A subduroperitoneal (SP) shunt was inserted in those patients in whom re-accumulation of the subdural collection had occurred. Of 33 patients, 17 were definitively treated by CESD and 16 subsequently needed an SP shunt. The cost of treatment with CESD was just less than half the cost of treatment with SP shunting. CESD can be used as a step before SP shunting in the management of chronic infantile subdural collections, since it is effective without further treatment in half the patients and safer than subdural tapping.
    Type of Medium: Electronic Resource
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