Bulsara Ketan R, Villavicencio Alan T, Shah Anand J, McGirt Matthew J, George Timothy M
Pediatric Neurosurgery Service, Division of Neurosurgery, Duke University Medical Center, Durham, NC 27705, USA.
Surg Neurol. 2003 Jan;59(1):58-61; discussion 61-2. doi: 10.1016/s0090-3019(02)00942-4.
Tectal region tumors can lead to hydrocephalus secondary to aqueductal compression. Surgical options for these patients include extracranial cerebrospinal fluid (CSF) shunts, third ventriculostomy, and/or aqueductal plasty. In cases of third ventriculostomy failure, the accepted alternative is an extracranial CSF shunt. We report a patient in whom a repeat third ventriculostomy with aqueductal plasty and stenting was successful after a failed initial third ventriculostomy.
A 12-year-old patient with hydrocephalus secondary to a tectal tumor presented with headaches and blurry vision. She had no focal neurologic findings. She underwent a third ventriculostomy. Five months after the procedure she had recurrence of her symptoms. Therefore, she underwent a secondary third ventriculostomy with aqueductal plasty and stenting. She has been symptom-free for 1 year.
Aqueductal plasty with stenting may be an alternative to CSF shunts in some patients with hydrocephalus because of aqueductal compression resulting from tectal tumors.
顶盖区肿瘤可导致因导水管受压继发的脑积水。这些患者的手术选择包括颅外脑脊液分流术、第三脑室造瘘术和/或导水管成形术。在第三脑室造瘘术失败的情况下，公认的替代方法是颅外脑脊液分流术。我们报告了一例患者，其初次第三脑室造瘘术失败后，再次进行第三脑室造瘘术并联合导水管成形术和支架置入术获得成功。
一名12岁因顶盖肿瘤继发脑积水的患者出现头痛和视力模糊。她没有局灶性神经系统体征。她接受了第三脑室造瘘术。术后五个月症状复发。因此，她接受了二次第三脑室造瘘术并联合导水管成形术和支架置入术。她已无症状1年。
对于一些因顶盖肿瘤导致导水管受压引起脑积水的患者，导水管成形术联合支架置入术可能是脑脊液分流术的一种替代方法。
