Myelo meningocele Table 1 Numbers of prenatally diagnosed cases by disease Post intraventricular hemorrhage Hydrocephalus Genetic or karyographic abno

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1 特集小児脳神経外科 Long Term Outcome of Prenatally Diagnosed Neurosurgical Diseases Masahiro Nonaka, M.D. 1, Mami Yamasaki, M.D. 2, and Akio Asai, M.D. 1 Key words Jpn J Neurosurg Tokyo , 2017 はじめに Jpn J Neurosurg VOL. 26 NO

2 Myelo meningocele Table 1 Numbers of prenatally diagnosed cases by disease Post intraventricular hemorrhage Hydrocephalus Genetic or karyographic abnormality Hydranen cephaly Isolated ventriculomegaly Brain tumor Arachnoid cyst Encephalocele Others Total Born alive Aborted Total Table 2 Numbers of prenatally diagnosed cases and timing of initial diagnosis Total Born alive Aborted Total Table 3 Prognosis of life and timing of initial diagnosis Total Died before 1 y. o Died after 1 y. o Alive Table 4 Developmental prognosis and timing of initial diagnosis 対象方法 Total DQ IQ DQ IQ DQ IQ Not examined Average DQ IQ developmental quotient DQ K 7 IQ Wechsler Intelligence Scale for Children WISC MRI Table 1 Table 1 結果出生前診断された時期 Table 2 出生した症例の予後 Table 3 DQ IQ Table 4 DQ IQ Table

3 Table 5 Prognosis of prenatally diagnosed myelomeningocele and timing of initial diagnosis Total Died before 1 y. o Died after 1 y. o DQ IQ DQ IQ DQ IQ Not examined Table 6 Prognosis of prenatally diagnosed hydrocephalus and timing of initial diagnosis Total Died before 1 y. o Died after 1 y. o DQ IQ DQ IQ DQ IQ DQ IQ Table DQ IQ Table 6 DQ IQ isolated ventriculomegaly 1 3 DQ IQ 50 1 DQ IQ Table 7 DQ IQ Table 7 Prognosis of prenatally diagnosed isolated ventriculomegaly and timing of initial diagnosis 考察 Total Died before 1 y. o Died after 1 y. o DQ IQ DQ IQ DQ IQ Donald alpha fetoprotein MRI 1980 Jpn J Neurosurg VOL. 26 NO

7 1984 Chervenak 6 13 26 21 44 14 28 14 2 1988 Hudgins 9 47 15 31 32 13 40 30 62

21 8 38 22 23 22 13 60 1990 Oi 12 2012 Yamasaki 15 MRI 20 Fig.

4 Chervenak Hudgins * Fig. 1 Sagittal heavily T2 weighted MR image of prenatally diagnosed myelomeningocele. Chiari malformation asterisk and meninigocele arrows are visualized Oi Yamasaki 15 MRI 20 Fig A B Fig. 2 Coronal heavily T2 weighted MR image of prenatally diagnosed interhemispheric arachnoid cyst A and intrauterine intraventricular hemorrhage B

5 MRI まとめ COI COI COI COI 文献 1 Adzick NS, Thom EA, Spong CY, Brock JW 3rd, Burrows PK, Johnson MP, Howell LJ, Farrell JA, Dabrowiak ME, Sutton LN, Gupta N, Tulipan NB, D Alton ME, Farmer DL MOMS Investigators A randomized trial of prenatal versus postnatal repair of myelomeningocele. N Engl J Med , Brock DJ, Sutcliffe RG Alpha fetoprotein in the antenatal diagnosis of anencephaly and spina bifida. Lancet , Brock DJ, Bolton AE, Scrimgeour JB Prenatal diagnosis of spina bifida and anencephaly through maternal plasma alpha fetoprotein measurement. Lancet , Campbell S An improved method of fetal cephalometry by ultrasound. J Obstet Gynaecol Br Commonw , Campbell S, Pryse Davies J, Coltart TM, Sellea MJ, Singer JD Ultrasound in the diagnosis of spina bifida. Lancet , Chervenak FA, Duncan C, Ment LR, Hobbins JC, McClure M, Scott D, Berkowitz RL Outcome of fetal ventriculomegaly. Lancet , Clewell WH, Johnson ML, Meier PR, Newkirk JB, Zide SL, Hendee RW, Bowes WA Jr, Hecht F, O Keeffe, Henry GP, Shikes RH A surgical approach to the treatment of fetal hydrocephalus. N Engl J Med , Donald I, Macvicar J, Brown TG Investigation of abdominal masses by pulsed ultrasound. Lancet , Hudgins RJ, Edwards MS, Goldstein R, Callen PW, Harrison MR, Filly RA, Golbus MS Natural history of fetal ventriculomegaly. Pediatrics , Makowski EL, Prem KA, Kaiser IH Detection of sex of fetuses by the incidence of sex chromatin body in nuclei of cells in amniotic fluid. Science , Nagaraj UD, Bierbrauser KS, Peiro JL, Kline Fath BM Differentiating closed versus open spinal dysraphisms on fetal MRI. AJR Am J Roentgenol , Oi S, Matsumoto S, Katayama K, Mochizuki M Pathophysiology and postnatal outcome of fetal hydrocephalus. Childs Nerv Syst , Reed MF Ultrasound in diagnosing hydrocephalus. Br Med J 3 762, Steele MW, Breg WR Jr Chromosome analysis of human amniotic fluid cells. Lancet , Yamasaki M, Nonaka M, Bamba Y, Teramoto C, Ban C, Pooh RK Diagnosis, treatment, and long term outcomes of fetal hydrocephalus. Semin Fetal Neonatal Med , Jpn J Neurosurg VOL. 26 NO

6 要旨 DQ IQ 脳外誌 26: ,

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A indd 184 Dementia Japan 24 : 184-190, 2010 原著要旨 davf davf 128 6 MRI SPECT 12% S 25% Characteristic of a dural arteriovenous fistulae (davf)producing symptoms of dementia Sachio Suzuki 1, Akira Kurata 1, Satoshi