THE RELATIONSHIP OF NON-PROGRESSIVE HYDROCEPHALUS TO INTELLECTUAL FUNCTIONING IN CHILDREN WITH SPINA BIFIDA CYSTICA

Abstract

Seventy-five patients with variable degrees of spinal cord dysfunction secondary to spina bifida cystica have been studied with special reference to their neurological and psychological status. Their ages ranged from 5 to 21 years. The patients were divided into five different groups on the basis of functional disability secondary to spinal cord dysfunction. Those patients with a history of rapid head enlargement and who had not had neurosurgical treatment for this problem comprised 62% of the population studied (total seventy-five). These patients were considered to have non-progressive hydrocephalus. The hydrocephalic subgroup scored lower in psychological testing and presented a significant discrepancy between verbal and performance scores which could be considered a characteristic sign of brain damage. The psychological test scores of the patient with the same severe paralytic defect but without hydrocephalus were essentially normal. The physical rehabilitation potential of these patients is dependent upon the degree of physical disability, but their over-all rehabilitation achievement is largely determined by their intellectual capacity and psychosocial adjustment. We believe that if we are to improve the long-range prognosis of such children, one of the objectives of neurosurgery should be early and effective treatment of the hydrocephalus.