颅脑手术对痉挛性四肢瘫痪脑瘫患者生活方式的改善

None Md Faridul Islam Chowdhury
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引用次数: 0

摘要

几种治疗方案可能有助于改善脑瘫(CP)患儿的日常功能。然而,这些治疗不能防止过早死亡,也不能使他们在没有支持的情况下独立生活。CP是一种进行性疾病,即使在其较温和的形式下,帕金森病、癫痫和中风等疾病也可能在25年后发展。利用双侧颅骨成形术和硬脑膜成形术(Tanfarid手术)治疗CP的新时代已经出现。本案例报告描述了一个采用此过程的成功案例。术中,开颅取颅骨后,观察到无硬脑膜搏动,提示颅内压升高。硬脑膜成形术后,观察到正常的脑搏动,表明颅内压已恢复正常。CP患者缝合线过早闭合,颅骨增厚,导致颅内体积减小,阻碍大脑正常生长,最终导致脑萎缩,脑西尔维问题扩大,脑沟扩大,并伴有脑实质组织的丧失。这些发现在患者的脑部CT扫描中也很明显。在这种情况下,颅骨成形术和硬脑膜成形术为大脑的生长提供了足够的空间。CP患者的治疗通常涉及多学科的方法,这可能是昂贵的。然而,在这种情况下使用的程序是该国经济上处于不利地位的个人负担得起的。虽然在某些情况下可能需要进行第二次颅脑手术,但与终身物理治疗和其他支持性治疗相比,与此相关的费用要低得多。此外,结果是非常有希望的。《医药学刊》第14卷第02期,2023年7月:105-108。
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Satisfactory Improvement in Lifestyle of a Spastic Quadriplegic Cerebral Palsy Patient through Cranial Surgery
Several treatment options may help improve daily functioning in children with cerebral palsy (CP). However, these treatments cannot prevent early death or enable them to lead independent life without support. CP is a progressive disease, and even in its milder form, conditions such as Parkinson's disease, epilepsy, and stroke may develop even after 25 years. A new era of curable treatment has emerged for CP, utilizing bilateral cranioplasty and duraplasty (Tanfarid Procedure). This case report describes a successful case where this procedure was employed. During the surgery, after the removal of cranial bones through craniotomy, the absence of dural pulsation was observed, indicating elevated intracranial pressure. After duraplasty, normal brain pulsation was observed, indicating that intracranial pressure had normalized. In patients with CP, premature closure of sutures and thickening of skull bones lead to a reduced intracranial volume, which hinders proper brain growth and eventually results in brain atrophy, widened Sylvian issures, and widened sulci accompanied by the loss of brain parenchymal tissue. These findings were also evident in the patient's brain CT scan. In this case, cranioplasty and duraplasty provided adequate space for the brain to grow . The treatment of CP patients typically involves a multidisciplinary approach, which can be expensive. However, the procedure utilized in this case is affordable for economically disadvantaged individuals in this country. While a second cranial surgery may be required in some cases, the expenses associated with it are significantly lower compared to a lifetime of physiotherapy and other supportive treatments. Additionally, the outcomes are very promising.KYAMC Journal Vol. 14, No. 02, July 2023: 105-108.
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