Abstract:
BACKGROUND:Neurological complications occur commonly in children with meningomyelocele and can cause significant morbidity and mortality. An earlier study suggested that acute changes in grip and pinch strength could be used to identify individuals at increased risk for developing a neurological complication. OBJECTIVE:To evaluate the use of grip and pinch measurements to screen for neurological problems in children with spina bifida and hydrocephalus. DESIGN:A prospective evaluation of screening tests. PATIENTS:92 children, born since 1976, who had meningomyelocele and hydrocephalus and were treated at the University of Rochester Medical Center. METHODS:Grip and pinch strength were measured between July, 1991, and June, 2003. RESULTS:Mean grip and pinch strengths were similar to those found in previous studies of children with meningomyelocele; 58 neurological events occurred in 39 (40%) individuals. These included 31 episodes of ventricular shunt failure and 22 symptomatic tethered cord occurrences. Specificity, sensitivity and likelihood ratios were calculated in multiple ways using different criteria for loss of grip or pinch strength and for interval to neurological event. Sensitivities were low (<0.35) and the highest positive likelihood ratio found, using fall in either lateral pinch with 6 months to neurological event, was 2.3. CONCLUSIONS:Despite previous recommendations, grip and pinch measurements were not helpful when used as a routine screening test for neurological dysfunction for children with meningomyelocele and hydrocephalus.
journal_name
Pediatr Neurosurgjournal_title
Pediatric neurosurgeryauthors
Liptak GS,Fried R,Baltus-Hebert E,Eyer Tierney S,Fucile S,Doremus TLdoi
10.1159/000092356subject
Has Abstractpub_date
2006-01-01 00:00:00pages
208-13issue
4eissn
1016-2291issn
1423-0305pii
92356journal_volume
42pub_type
杂志文章abstract::Though detected with increasing frequency, intracranial carotid artery dissection remains less common in infancy. We report on 3 otherwise healthy children aged 8, 12 and 15 years who presented with focal headache and stroke secondary to intracranial carotid occlusive disease consistent with arterial dissection. In 2 ...
journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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journal_title:Pediatric neurosurgery
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