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Florin Brezan

Latest posts by Florin Brezan (see all)

  • MALFORMATIE CEREBRALA EXTREMA – CONSIDERATII CLINICE SI ETICE PE MARGINEA UNUI CAZ - 21/07/2015
  • EXTREME CEREBRAL MALFORMATION – CLINICAL AND ETHICAL ISSUES BASED ON A CASE - 17/07/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

MALFORMATIE CEREBRALA EXTREMA – CONSIDERATII CLINICE SI ETICE PE MARGINEA UNUI CAZ

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 4, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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MALFORMATIE CEREBRALA EXTREMA – CONSIDERATII CLINICE SI ETICE PE MARGINEA UNUI CAZ

Florin Brezan, Ioana Codreanu, Rodica Cretu, Lucica Ghita, Mirela Ritivoiu, Diana Goran and Ioana Alina Anca

REZUMAT

Hidranencefalia reprezintă una dintre malformaţiile cerebrale extrem de rară şi cu prognostic nefavorabil, cu impact psihoafectiv negativ asupra familiei şi societăţii. În mod obişnuit, cei afectaţi rămân într-o stare vegetativă permanentă şi necesită îngrijiri pe termen nelimitat. Deşi majoritatea celor afectaţi decedează în primele zile-luni de viaţă, o parte dintre ei supravieţuiesc până în decada a 2-a a 3-a de viaţă. Din punct de vedere al tratamentului, îngrijirile acordate sunt pur paliative şi sunt îndreptate spre menţinerea funcţiilor vitale.

Concluzii. Hidranencefalia reprezintă o malformaţie cerebrală rară, cu prognostic rezervat şi speranţă de viaţă şi calitate a vieţii scăzute. Diagnosticul impune o serie de probleme etice. Importanţa diagnosticului prenatal se impune prin faptul că hidranencefaliare prezintă indicaţie de avort terapeutic. O altă problemă etică o ridică îngrijirile medicale acordate, ce sunt pur paliative, pacienţii fiind în stare vegetativă permanentă. Atât instituirea tratamentului chirurgical pentru drenajul cantităţii excesive al LCR, cât şi metodele noi terapeutice descrise în literatură, de tipul coagulării endoscopice a plexurilor choroide, nu influenţează statusul neurologic şi dezvoltarea neuropsihomotorie a pacienţilor. Toate aceste date trebuie explicate clar aparţinătorilor, pentru a nu-şi ridica speranţe false în ceea ce priveşte evoluţia acestor bolnavi.

Cuvinte cheie: hidranencefalie, ecografie transfontanelară, hemoragie periintraventriculară, prematuritate

Full text | PDF

Florin Brezan

EXTREME CEREBRAL MALFORMATION – CLINICAL AND ETHICAL ISSUES BASED ON A CASE

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 4, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EXTREME CEREBRAL MALFORMATION – CLINICAL AND ETHICAL ISSUES BASED ON A CASE

Florin Brezan, Ioana Codreanu, Rodica Cretu, Lucica Ghita, Mirela Ritivoiu, Diana Goran and Ioana Alina Anca

ABSTRACT

Hydranencephaly represents one of the most rare cerebral malformations, with poor prognosis and negative impact on both family and society. Usually the patients remain in a permanent vegetative state and require unlimited medical care. Although the majority of affected babies die in utero or in the fi rst days-months of life there have been cases in literature with prolonged survival, for 20 (1), 22 (2) and 32 (3) years. Therapeutically, the medical care provided are purely palliative and oriented to supporting vital function.

Conclusions. Hydranencephaly is a rare brain malformation with poor prognosis, life expectancy and quality of life. Diagnosis imposes a number of ethical issues. The importance resides in the fact that prenatal detection represents an indication for therapeutic abortion. Another ethical issue raised is represented by medical care provided, which is exclusively palliative. Both surgical and novel therapeutic methods described by the literature, like endoscopic coagulation of choroid plexes, do not infl uence the neurological status and the neuropsychomotordevelopment (4). All this data should be clearly explained to parents and legal tutors for not raising any false hopes regarding the evolution.

Keywords: hydranencephaly, transfontanellar ultrasound, peri/intraventricular hemorrhage, prematurity

Full text | PDF

Florin Brezan


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