分流器移入蝶窦：病例报告
Shunt migration into the sphenoid sinus: case report.
作者信息
Li Khan W, Ciceri Elisa, Lasio Giovanni, Solero Carlo L, DiMeco Francesco
机构信息
Department of Neurological Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
出版信息
Neurosurgery. 2003 Aug;53(2):441-3; discussion 443. doi: 10.1227/01.neu.0000073993.14329.4f.
OBJECTIVE AND IMPORTANCE
Shunt catheter migration is a potential complication of cerebrospinal fluid shunting procedures. We report an unusual case of proximal shunt migration into the sphenoid sinus. To our knowledge, there have been no previous reports of shunt migration through the bony structures of the cranial base.
CLINICAL PRESENTATION
A 41-year-old man who had had a cyst-to-peritoneum shunt placed 21 years earlier for a temporal lobe arachnoid cyst presented with cerebrospinal fluid rhinorrhea. Neuroradiological imaging revealed migration of the shunt catheter through the medial wall of the middle temporal fossa into the sphenoid sinus.
INTERVENTION
The patient underwent shunt removal and repair of the dural defect. Intraoperatively, the proximal catheter tip was found in the sphenoid sinus with dural and bony erosion. The patient made an uneventful recovery.
CONCLUSION
We present a unique long-term complication associated with intracranial shunt catheters. We hypothesize that excessive proximal catheter length and chronic cerebrospinal fluid pulsations contributed to migration of the catheter into the sphenoid sinus.
目的及重要性
分流导管移位是脑脊液分流手术的一种潜在并发症。我们报告一例罕见的近端分流导管移位至蝶窦的病例。据我们所知，此前尚无分流导管通过颅底骨质结构移位的报道。
临床表现
一名41岁男性，21年前因颞叶蛛网膜囊肿行囊肿 - 腹腔分流术，现出现脑脊液鼻漏。神经放射学成像显示分流导管经颞中窝内侧壁移位至蝶窦。
干预措施
患者接受了分流导管移除及硬脑膜缺损修复术。术中发现近端导管尖端位于蝶窦内，伴有硬脑膜和骨质侵蚀。患者术后恢复顺利。
结论
我们呈现了一种与颅内分流导管相关的独特长期并发症。我们推测，近端导管过长及慢性脑脊液搏动促使导管移位至蝶窦。
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