EFFECT OF THE CAROTID-JUGULAR-ANASTOMOSIS OPERATION UPON INTELLIGENCE

[摘要] The psychologic findings on 33 children following the c-j-a operation have been reported. The results show that almost all the patients improved in mental age but only at the same rate, in comparison with the chronologic age, which was evident prior to the operation. There was one instance of significantly increased rate with an I.Q. improvement of 18 points, and one instance of significantly decreased rate with an I.Q. loss of 20 points. The average difference in I.Q. following surgery was slight and in a minus direction.Certain sources of confusion in evaluating intellectual changes have been discussed. A change in I.Q. within 10 points sometimes occurs with repeated tests for no specific reason beyond the measuring error inherent in the intelligence test. The mere fact of improved functioning in a child means little as far as evaluating surgical intervention is concerned, since most children are still in the process of growth, although it may be slow. Moreover, individual I.Q.'s obtained before the chronologic age of 3 years should be interpreted with discretion; this is particularly true in the case of spastic children who, in standard tests, are unfairly handicapped on a purely physical basis.On the basis of the data reported in this study, the previous claim that "this procedure represents the first successful attempt at correction of mental retardation on an organic basis" is not fulfilled. Although in previous reports by Beck, McKhann and Belnap, the concept of the I.Q. is used freely in general statements, no statistical facts have been provided. The improvement in two cases presented in the first published report by these authors has not been sustained by later study. The statement that children with I.Q.'s between 40 and 60 show the greatest improvement is contradicted by the present author's findings. There is virtually no evidence in this study (significant improvement in one case out of 33) for crediting the c-j-a surgical procedure with improvement of the intellect. The majority of the cases herein reported were tested several months after surgery so that whatever improvement was going to occur should have been manifest, according to the statement of McKhann, Belnap and Beck that "improvement usually begins to appear in the retarded children within the first two postoperative months."

[学科分类] 儿科学