Prospective, declarative and nondeclarative memory in young adults with spina bifida
The consequences of congenital brain disorders for adult cognitive function are poorly understood. We studied different forms of memory in 29 young adults with SBM, a common and severely disabling neural tube defect. Nondeclarative and semantic memory functions were intact. Working memory was intact with low maintenance and manipulation requirements, but impaired on tasks demanding high information maintenances or manipulation load. Prospective memory for intentions to be executed in the future was impaired. Immediate and delayed episodic memory were poor. An increased number of lifetime shunt revisions, a marker for unstable hydrocephalus, exacerbated memory deficits. Memory status was positively correlated with functional independence, an important component of quality of life.
JINS 2007, 13, 312-323
Failure of cerebrospinal fluid shunts: Part 1: Obstruction and Mechanical Failure
Shunt dysfunction results from a broad spectrum of aetiologies ranging from surgeon-related complications to isolated shunt materials failure to concurrent medical illnesses. Although the patient history and physical examination provide the initial suspicion of shunt failure, medical imaging often confirms the diagnosis and reveals the underlying cause. An understanding of the specific types of obstructive shunt malfunction, the potential causes of failure, and management options is important for neurologists and paediatricians who often are the first providers to evaluate and triage these often markedly ill children.
Ped Neurol 2006 34;2:83-92
Failure of cerebrospinal fluid shunts: Part II: Overdrainage, Loculation and Abdominal complications
Many shunts are prone to failure and these problems have defied clinical research efforts and elegant shunt designs. It is therefore important that primary care physicians, paediatricians, and neurologists are familiar with these events because they are often the first physicians to evaluate these patients. Continued vigilance and prompt management of these problems are required to optimise the quality of life for hydrocephalic patients.
Ped Neurol 2006 34;2:171-176
CSF Shunt failure with stable normal ventricular size
Ventricular enlargement is a common but not sine qua non indicator of CSF shunt failure, even after weeks or months of elevated intracranial pressure, and therefore cannot be relied upon for the diagnosis of CSF shunt failure. Although an increase in ventricular size is usually seen relatively early in the course of shunt malfunction, stable normal ventricular size in patients with symptoms and signs that are consistent with shunt failure can delay the diagnosis with potentially serious adverse consequences.
Urodynamic findings in children with myelomeningocele after untethering of the spinal cord
After untethering secondary to myelomeningocele, 35% of the patients experienced improved bladder function and 5% deteriorated. All of the patients who deteriorated before untethering improved afterward, and 90% of those who were stable preoperatively continued to be stable postoperatively. Therefore regular evaluation of bladder function in children with myelomeningocele should be performed.
J Urol 2007;177:331-334
Assistive technology use among adolescents and young adults with spina bifida
Adolescents and young adults with spina bifida rely on assistive technology and specialised care routines to maintain their health. Assistive technology use for mobility is common; little is known about secondary complications associated with the use of these technologies or the use of assistive technology to address learning disabilities and other societal barriers. Underutilisation of assistive technology could delay successful transitions to independent living and community participation.
Am J Public Health 2007;97:330-336
Perineal sensation: an important predictor of long term outcome in open spina bifida
A simple assessment of perineal sensation in infancy predicts long-term outcome in terms of survival, renal prognosis and incontinence in open spina bifida.
Arch Dis Child 2007;92:67-70