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2015, Number 1

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Rev Cubana Pediatr 2015; 87 (1)

Neuropsychological alterations found in patients with prehepatic portal hypertension

Torres NYL, Trinchet SRM, Cárdenas SH, Rodríguez CL, Fonseca PI

Language: Spanish
References: 17
Page: 31-39
PDF size: 164.17 Kb.


ABSTRACT

Introduction: in the prehepatic portal hypertension secondary to thrombotic obstruction, there may appear neurocognitive disorders similar to systemic encephalopathy seen in chronic hepatic illnesses. This portal hypertension may be clinically well-defined or occurs in a subacute form currently known as minimal hepatic encephalopathy. This consists of neurophyshcological deficits in patients without alterations in the routine neurological exploration. It is difficult to study it in children due to lack of standardized neuropsychological tests for all ages.
Objectives: to identify the presence of neupsychological alterations in pediatric patients with prehepatic portal hypertension.
Methods: twelve patients with prehepatic portal hypertension secondary to umbilical catheterism were studied through different psychological techniques. The study variables were age, time of progression of disease, initial clinical form, neuropsychological alterations and surgical procedure used.
Results: predominance of patients aged 10 to 14 years and time of progression ranging 6 to 10 years. The upper digestive bleeding was the most common initial clinical form. Eleven patients showed deficit in involuntary attention, focused attention, immediate memory and dynamics of the memorizing activity. Eight patients suffered problems in the operational aspect of their thinking and 6 had the dynamics of their thinking affected. Most of children with neuropsychological alterations were not operated on.
Conclusions: there are predictive disorders of minimal hepatic encephalopathy in patients suffering prehepatic portal hypertension. The failure to use the surgical treatment may be related to occurrence of neuropsychological alterations. Theoretically speaking, the solution would lie in performing early portoportal shunts or procedures eliminating the portal obstruction. It is necessary to delve into this research and generalize the results to the rest of patients diagnosed with this disease.


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