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The transition from child to adult in neurosurgery

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 32))

Abstract

The transition from child to adult is a growing concern in neurosurgery. Data documenting long-term follow-up are necessary to define this population’s healthcare needs. In order to evaluate the problems posed by the child-to-adult transition in neurosurgery, we have studied the neurological, functional and social outcome of patients treated in our department for tumor of the central nervous system, hydrocephalus or myelomeningocele, and followed beyond the age of eighteen years. A large number of patients suffered from chronic ailments, either sequelae of their initial disease, or delayed complications of their initial treatment, with significant morbidity. The mortality during adulthood was 4.6% in the tumor group, 1.1% in the hydrocephalus group, and zero in the spina bifida group. The proportion of patients employed in normal jobs was 35.6, 18.7 and 11.5% for tumors, hydrocephalus and myelomeningocele respectively. IQ score and performance at school generally overestimated the capacity for social integration. Based on these data and on the available literature, we tried to identify the problems and devise solutions for the management of the transition from child-to-adulthood transition. Many problems present during childhood persist to adulthood, some of which are made more acute because of a more competitive environment, the lack of structures and inadequate medical follow-up. The transition from child to adult must be managed jointly by pediatric and adult neurosurgeons. More clinical research is required in order to precisely evaluate the problems posed by adult patients treated during childhood for the different neurosurgical diseases. Based on these data, a concerted trans-disciplinary approach is necessary, tailored to the specific needs of patients suffering from different diseases.

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References

  1. American Academy of Pediatrics (2002) A consensus statement on health care transitions for young adults with special health care needs. Pediatrics 100: 1304–1306

    Google Scholar 

  2. Amlashi SFA, Riffaud L, Brassier G, Morandi X (2003) Nevoid basal cell carcinoma syndrome: relation with desmoplastic medulloblastoma in infancy. Cancer 98: 618–624

    Article  PubMed  Google Scholar 

  3. Anderson CA, Wilkening GN, Filley CM, Reardon MS, Kleinschmidt-DeMasters BK (1997) Neurobehavioral outcome in pédiatric craniopharyngioma. Pediatr Neurosurg 26: 255–260

    Article  PubMed  CAS  Google Scholar 

  4. Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA (2001) Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg 34: 114–120

    Article  PubMed  CAS  Google Scholar 

  5. Casey ATH, Kimmings EJ, Kleinlugtebeld AD, Taylor WAS, Hayward RD (1997) The longterm outlook for hydrocephalus in childhood. Pediatr Neurosurg 27: 63–70

    PubMed  CAS  Google Scholar 

  6. Czech T, Slavc I, Aichholzer M, Haberler C, Dietrich W, Dieckmann K, Koos W, Budka H (1999) Proliferative activity as measured by MIB-1 labeling index and long-term outcome of visual pathway astrocytomas in children. J Neurooncol 42: 143–150

    Article  PubMed  CAS  Google Scholar 

  7. Defoort-Dhellemmes S, Moritz F, Bouacha I, Vinchon M (2006) Craniopharyngioma: ophthalmological aspects at diagnosis. J Pediatr Endocrinol Metab 19 Suppl 1: 322–324

    Google Scholar 

  8. Dhellemmes P, Vinchon M (2006) Radical resection for craniopharyngiomas in children: surgical technique and clinical results. J Pediatr Endocrinol Metab 19 Suppl 1: 329–335

    PubMed  Google Scholar 

  9. Drake J, Chumas P, Kestle J, Pierre-Kahn A, Vinchon M (2006) Late Rapid Deterioration after endoscopie third ventriculostomy — additional cases and literature review J Neurosurg 105 Suppl 2: 118–126

    PubMed  Google Scholar 

  10. Foreman NK, Faestel PM, Pearson J, Disabato J, Poole M, Wilkening G, Arenson EB, Greffe B, Thorne R(1999) Health status in 52 long-term survivors of pediatric brain tumors. J Neurooncol 41: 47–53

    Article  PubMed  CAS  Google Scholar 

  11. Gleeson HK, Shalet SM(2004) The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours. Endocrine-Related Cancer 11: 589–602

    Article  PubMed  CAS  Google Scholar 

  12. Green DM, Fiorello A, Zevon MA, Hall B, Seigelstein N(1997) Birth defects and childhood cancer in offspring of survivors of childhood cancer. Arch Pediatr Adolesc Med 151: 379–383

    PubMed  CAS  Google Scholar 

  13. Grill J, Viguier D, Kieffer V, Bulteau C, Sainte-Rose C, Hartmann O, Kalifa C, Dellatolas G (2004) Critical risk factors for intellectual impairment in children with posterior fossa tumors: the role of cerebellar damage. J Neurosurg Pediatrics 101 Suppl 2: 152–158

    Google Scholar 

  14. Herbeau C(2004) Devenir à long terme de patients présentant une myéloméningocèle à la naissance nés entre 1981 et 1982 dans le nord de la France [Outcome of patients with myelomeningocele born between 1981 and 1982 in the north of France]. Dissertation for Medical Thesis, Lille

    Google Scholar 

  15. Hetherington R, Dennis M, Barnes M, Drake J, Gentili F(2006) Functional outcome in young adults with spina bifida and hydrocephalus. Child’s Nerv Syst 22: 117–124

    Article  CAS  Google Scholar 

  16. Hoffman AR, Kuntze JE, Baptista J, Baum HBA, Baumann GP, Biller BMK, Clark RV, Cook D, Inzucchi SE, Kleinberg D, Kliblanski A, Phillips LS, Ridgway EC, Robbins RJR, Schlechte JS, Sharma M, Thorner MO, Vance ML (2004) Growth hormone (GH) replacement therapy in adult-onset GH deficiency: effects on body composition in men and women in a double-blind, randomized, placebo-controlled trial. J Clin Endoc Metab 89: 2048–2056

    Article  CAS  Google Scholar 

  17. Hoppe-Hirsch E, Renier D, Lellouch-Tubiana A, Sainte-Rose C, Pierre-Kahn A, Hirsch JF (1990) Medulloblastoma in childhood: progressive intellectual deterioration. Child’s Nerv Syst 6: 60–65

    Article  CAS  Google Scholar 

  18. Hunt GM, Oakeshot P, Kerry S(1999) Link between the CSF shunt and achievement in adults with spina bifida. J Neurol Neurosurg Psychiatr 67: 591–595

    PubMed  CAS  Google Scholar 

  19. Kang JK, Lee IW(1999) Long-term follow-up of shunting therapy. Child’s Nerv Syst 15: 711–717

    Article  CAS  Google Scholar 

  20. Kennedy C, Glaser A(2004) Quality of survival. In: Walker DA, Perilongo G, Punt JAG, Taylor RE (eds) Brain and spinal tumors of childhood. Arnold, London, pp 493–500

    Google Scholar 

  21. Lonser RR, Walbridge S, Vortmeyer AO, Pack SD, Nguyen TT, Gobate N, Olson JJ, Bobo RH, Goffman T, Shunang Z, Oldfield EH(2002) Induction of glioblastoma in nonhuman primates after therapeutic doses of fractionated whole-brain radiation therapy. J Neurosurg 97: 1378–1389

    PubMed  Google Scholar 

  22. McLone DG(1995) The adult with a tethered cord. Clin Neurosurg 43: 203–209

    Google Scholar 

  23. Mulhern RK, Kun LE(1999) Cognitive deficits. In: Berger MS, Wilson CB (eds) The gliomas. Saunders, Philadelphia, pp 741–749

    Google Scholar 

  24. Nicholson HS, Butler R(2001) Late effects of therapy in long-term survivors. In: Keating RF, Goodrich JT, Packer RJ (eds) Tumors of the pediatric central nervous system. Thieme, New York, pp 535–545

    Google Scholar 

  25. Packer RJ, Gurney JG, Punyko JA, Donaldson SS, Inskip PD, Stovall M, Yasui7 Y, Mertens AC, Sklar CA, Nicholson HS, Zeltzer LK, Neglia JP, Robison LL(2003) Long-term neurologic and neurosensory sequelae in adult survivors of a childhood brain tumor: childhood cancer survivor study. J Clin Oncol 21: 3255–3261

    Article  PubMed  Google Scholar 

  26. Palmer SL, Goloubeva O, Reddick WE, Glass JO, Gajjar A, Kun L, Merchant TE, Mulhern RK(2001) Patterns of intellectual development among survivors of pediatric medulloblastoma: a longitudinal analysis. J Clin Oncol 19: 2302–2308

    PubMed  CAS  Google Scholar 

  27. Park TS(1999) Myelomeningocele. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of pediatric neurosurgery. Thieme, New York, pp 291–320

    Google Scholar 

  28. Pergener TV, Leplège A, Etter JF, Rougemont A(1995) Validation of a French-language version of the mos 36-item short form health survey (SF-36) in young healthy adults. J Clin Epidemiol 48: 1051–1060

    Article  Google Scholar 

  29. Rekate HL(1999) Treatment of hydrocephalus. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and practice of pediatric neurosurgery. Thieme, New York, pp 47–73

    Google Scholar 

  30. Sainte-Rose C, Puget S, Wray A, Zerah M, Grill J, Brauner R, Boddaert N, Pierre-Kahn A (2005) Craniopharyngioma: the pendulum of surgical management. Child’s Nerv Syst 21: 691–695

    Article  Google Scholar 

  31. Sgouros S, Mallucci C, Walsh AR, Hockley AD(1995) Long-term complications of hydrocephalus. Pediatr Neurosurg 23: 127–132

    PubMed  CAS  Google Scholar 

  32. Shurtleff DB, Duguay S, Duguay G, Moskowitz D, Weinberger E, Roberts T, Loeser J(1997) Epidemiology of tethered cord with meningomyelocele. Eur J Pediatr Surg 7 Suppl 1: 7–11

    Article  PubMed  Google Scholar 

  33. Sklar CA(1994) Craniopharyngioma: endocrine sequelae of treatment. Pediatr Neurosurg 21 Suppl 1: 120–123

    Google Scholar 

  34. Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB, Moshang T Jr, Lange B, Packer RJ (1995) Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. J Neurosurg 83: 583–589

    PubMed  CAS  Google Scholar 

  35. Tuffrey C, Pearce A(2003) Transition from pediatric to adult neurological services for young people with chronic neurological problems. J Neurol Neurosurg Psychiatr 74: 1011–1013

    Article  PubMed  CAS  Google Scholar 

  36. Vinchon M, Fichten A, Delestret I, Dhellemmes P(2003) Revision for asymptomatic shunt failure: surgical and clinical results. Neurosurgery 52: 347–356

    Article  PubMed  Google Scholar 

  37. Vinchon M, Leblond P, Noudel R, Dhellemmes P(2005) Intracranial ependymomas in childhood: recurrence, reoperation, and outcome. Child’s Nerv Syst 21: 221–226

    Article  Google Scholar 

  38. Vinchon M, Baroncini M, Thines L, Dhellemmes P(2006) Bowel perforation by peritoneal shunt catheters: diagnosis and treatment. Neurosurgery 58 Suppl 1: 76–82

    Article  Google Scholar 

  39. Vinchon M, Dhellemmes P(2006) Cerebrospinal shunt infection: risk factors and long term follow-up. Child’s Nerv Syst 22: 692–677

    Article  Google Scholar 

  40. Ware JE, Gandek B(1998) Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 51: 903–912

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Neurosurgery, Lille University Hospital, Lille-Cedex, France

    M. Vinchon & P. Dhellemmes

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  1. M. Vinchon
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  2. P. Dhellemmes
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Editor information

Editors and Affiliations

  1. Cambridge

    J. D. Pickard (Editor-in-Chief) (Editor-in-Chief)

  2. Ankara

    N. Akalan

  3. Roma

    C. Di Rocco

  4. Ljubljana

    V. V. Dolenc

  5. Lisbon

    J. Lobo Antunes

  6. Groningen

    J. J. A. Mooij

  7. Bonn

    J. Schramm

  8. Lyon

    M. Sindou

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© 2007 Springer-Verlag/Wien

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Vinchon, M., Dhellemmes, P. (2007). The transition from child to adult in neurosurgery. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 32. Springer, Vienna. https://doi.org/10.1007/978-3-211-47423-5_1

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  • DOI: https://doi.org/10.1007/978-3-211-47423-5_1

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-47416-7

  • Online ISBN: 978-3-211-47423-5

  • eBook Packages: MedicineMedicine (R0)

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