使用脑脊液分流术治疗一名患有活动性艾滋病相关隐球菌性脑膜炎且颅内压升高的患者。

Use of cerebrospinal fluid shunt for the management of elevated intracranial pressure in a patient with active AIDS-related cryptococcal meningitis.

作者信息

Mylonakis E, Merriman N A, Rich J D, Flanigan T P, Walters B C, Tashima K T, Mileno M D, van der Horst C M

机构信息

Department of Medicine, Miriam Hospital, Brown University School of Medicine, Providence, RI 02906, USA.

出版信息

Diagn Microbiol Infect Dis. 1999 Jun;34(2):111-4. doi: 10.1016/s0732-8893(99)00025-5.

DOI:10.1016/s0732-8893(99)00025-5

PMID:10354860

Abstract

Persistently elevated intracranial pressure (ICP) is one of the most accurate predictors of a poor prognosis in patients with AIDS-related cryptococcal meningitis. We present a severe case of persistent cryptococcal meningitis in a patient with advanced AIDS, complicated by elevation of ICP. A ventriculoperitoneal shunt was placed that successfully lowered the ICP and alleviated the associated symptoms. The elevated ICP secondary to AIDS-related cryptococcal meningitis should be treated aggressively. Despite the risk of shunt complications, cerebrospinal fluid shunts can be considered in these patients if they do not respond to other treatment.

摘要

持续性颅内压（ICP）升高是艾滋病相关隐球菌性脑膜炎患者预后不良最准确的预测指标之一。我们报告了一例晚期艾滋病患者发生的严重持续性隐球菌性脑膜炎病例，该病例并发颅内压升高。置入了脑室腹腔分流管，成功降低了颅内压并缓解了相关症状。对于艾滋病相关隐球菌性脑膜炎继发的颅内压升高应积极治疗。尽管存在分流并发症的风险，但如果这些患者对其他治疗无反应，可考虑进行脑脊液分流术。