Van Schaeybroeck P, Vanlommel E, Lagae L, Van Calenbergh F, Casaer P, Plets C
Department of Neurosurgery, University Hospital Leuven, Belgium.
Childs Nerv Syst. 1999 Mar;15(2-3):90-3. doi: 10.1007/s003810050339.
We describe the first observation of a child with a posterior fossa subdural effusion with secondary hydrocephalus and tonsillar herniation. We diagnosed this entity in a 14-month-old girl with no history of trauma or coagulation disorder. The patient presented in our emergency department with opisthotonus and raised intracranial pressure resulting from supratentorial hydrocephalus. An emergency ventriculo-peritoneal shunt was placed, which resolved the symptoms only temporarily. Eventually external drainage of the subdural fluid was performed. The collection gradually disappeared, and both the external subdural shunt and the ventriculo-peritoneal shunt were removed. The patient made a complete neurological recovery. We review the physiopathology and treatment of subdural effusions in general, and propose some guidelines for the management of symptomatic effusions occurring in the posterior fossa in particular.
我们描述了首例患有后颅窝硬膜下积液伴继发性脑积水和扁桃体疝的儿童的观察情况。我们在一名无创伤或凝血障碍病史的14个月大女孩中诊断出了这种疾病。该患者因幕上脑积水在我们急诊科表现为角弓反张和颅内压升高。进行了紧急脑室 - 腹腔分流术，但仅暂时缓解了症状。最终进行了硬膜下积液的外部引流。积液逐渐消失，硬膜下外部分流管和脑室 - 腹腔分流管均被移除。患者神经功能完全恢复。我们总体回顾了硬膜下积液的生理病理学和治疗方法，并特别提出了一些针对后颅窝出现的有症状积液的管理指南。
