文章摘要
刘云义,赵敬璞,倪莹莹,刘嘉发,马梦良,邓少勇,李国俊,成丽娜,吕晓,燕铁斌.先天性脑积水致皮质扁平样变对患者运动及认知功能的影响[J].中华物理医学与康复杂志,2017,39(10):753-755
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先天性脑积水致皮质扁平样变对患者运动及认知功能的影响
The impact of flat deformity of the cerebral cortex on motor functioning and cognition
  
DOI:
中文关键词: 先天性脑积水  皮质扁平样变  行为功能  认知功能
英文关键词: Congenital hydrocephalus  Cerebral cortex  Motor function  Cognitive function  Brain plasticity
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作者单位
刘云义,赵敬璞,倪莹莹,刘嘉发,马梦良,邓少勇,李国俊,成丽娜,吕晓,燕铁斌 510120 广州广东三九脑科医院神经康复科(刘云义、刘嘉发、马梦良、倪莹莹、吕晓)神经外七科(邓少勇)神经外三科(李国俊)影像科(成丽娜)中山大学孙逸仙纪念医院康复医学科(赵敬璞、燕铁斌) 
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中文摘要:
      目的 观察出生后脑积水致皮质扁平样变对患者行为及认知功能的影响,为脑损伤后遗症的康复提供依据。 方法 选取出生后脑积水患者3例,年龄20~33岁,经CT检测示脑皮质受压变扁明显。采用Fugl-Meyer运动量表(FMA)、Berg平衡量表(BBS)、简明精神状态(MMSE)和改良Barthel指数(MBI)分别评估患者的运动功能、平衡功能、认知功能和日常生活活动能力,采用临床交流法判断有无言语功能障碍,同时通过128层螺旋CT对3例患者脑皮质进行检查,并计算脑室大小指数。 结果 3例患者均接受过脑室腹腔分流术治疗,FMA评分分别为75.5分、83分、100分;BBS评分分别为4分、24分、56分;MMSE评分分别为14分、23分、26分;MBI评分分别为40分、90分、100分。CT示3例患者脑室均明显扩大,皮质明显受压变薄,最薄处分别为0.18cm、0.22cm、0.57cm;脑室大小指数为303%、288%、192%。 结论 出生后缓慢发生的脑积水患者在自然生存环境下,运动、认知、言语功能仍然可以有良好的发育,提示大脑具有极大的潜力和可塑性。
英文摘要:
      Objective To investigate the impact flat deformity of the cerebral cortex induced by congenital hydrocephalus on motor functioning and cognition. Methods Tomography was used to confirm the presence of flat cortex deformity in three congenital hydrocephalus patients ranging in age from 20 to 33. Their motor control, balance, cognition and ability in the activities of daily living (ADL) were evaluated using the Fugl-Meyer assessment (FMA), the Berg balance scale (BBS), the mini-mental state examination (MMSE) and the modified Barthel index (MBI). Speech dysfunction was judged on the basis of clinical communication. The patients were scanned using a 64-slice spiral CT and size-of-ventricle indices were calculated. Results All 3 patients underwent ventrideperitoneal shunt. Their FMA scores were 75.5, 83 and 100, with BBS scores of 4, 24 and 56, MMSE scores of 14, 23 and 26, and the MBIs of 40, 90 and 100. CT images showed obvious ventricle enlargement and a thinner cortex layer in all three, with the thinnest part 0.18 cm, 0.22 cm and 0.57 cm. Their ventricle indexes were 303%, 288% and 192%, respectively. Conclusion Although there is no systematic rehabilitation therapy for such patients, their motor, cognition and speech functioning were good, indicating the great potential for plasticity of the human brain.
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