Cognitive and functional outcome in XXXX .

@entity1 @entity1276 @entity75 @entity73 @entity1645 @entity1109 @entity3156 @entity281 @entity5033 @entity10
PURPOSE: The long-term outcome in @entity1645 complex is poorly understood. Traditional neurosurgical outcome measures are crude. Neuropsychological testing is increasingly important in outcome assessment. We investigated the health, disability, lifestyle and cognitive function in adults who had myelomeningocoele closure at birth. METHODS: Adult @entity1 under routine follow-up were assessed in a joint neurosurgery/neuropsychology clinic. @entity1 completed lifestyle questionnaires, the @entity1276 outcome questionnaire (HOQ) and underwent cognitive testing. Clinical variables including number of shunt revisions, @entity281 and surgical decompression of foramen magnum, which may influence outcome, were investigated. RESULTS: Twenty-one adults with a median age of 35 years were investigated. All had treated @entity1276 , and eight had foramen magnum decompression for @entity10 or progressive @entity1109 with stabilisation of symptoms in seven and improvement in one. Only eight @entity1 were living independently, five were in paid employment and five work voluntarily. HOQ scores for cognitive function were lower (0.56    0.20; mean    standard deviation (SD)) than those for physical (0.64    0.15) and @entity3156 . Cognitive function varied across the cohort with attention most severely affected (73.9    17.0; mean    SD). Repeated episodes of @entity5033 or foramen magnum decompression were not associated with a worse cognitive function. CONCLUSIONS: Despite intervention in childhood and adequate cerebrospinal fluid diversion the prognosis for independent living into adulthood remains poor. All @entity1 have elements of @entity73 . @entity75 may be more important determinants of cognitive outcome than @entity5033 .
