Dauch W A, Wranze-Bielefeld E, Lütcke A, Bauer B L
Neurochirurgische Klinik, Philipps-Universität, Marburg.
Monatsschr Kinderheilkd. 1992 Jun;140(6):357-62.
Decompensation of chronic idiopathic hydrocephalus can occur at every age, but seems to be rather frequent in the middle of the second decade. From this observation, the question arises, whether or not in these cases a special manifestation of hydrocephalus occurs and, should the situation arise, whether this finding might influence the discussion about pathogenesis.
We give some casuistic material about six hydrocephalic patients who became symptomatic between their 12th and 16th year of life.
All of these patients showed a tri-ventricular appearance of hydrocephalus as well as radiological signs of chronicly elevated intracranial pressure, while clinical signs and symptoms differed considerably. These findings are linked to the discussion of the pathogenesis of so-called aqueductal stenosis.
Whenever, after normal development in childhood, symptoms like increasing headache, poor concentration, dizziness or disturbances of gait appear during puberty, X-ray diagnosis of the skull is recommended. If it shows the signs of chronic elevated intracranial pressure, further investigations are necessary.
慢性特发性脑积水的失代偿可发生于任何年龄,但在第二个十年中期似乎较为常见。基于这一观察结果,出现了这样的问题,即在这些病例中是否会出现脑积水的特殊表现,以及如果出现这种情况,这一发现是否会影响关于发病机制的讨论。
我们给出了一些关于6例在12至16岁出现症状的脑积水患者的病例资料。
所有这些患者均表现出三脑室型脑积水以及颅内压慢性升高的影像学征象,而临床体征和症状差异很大。这些发现与所谓导水管狭窄发病机制的讨论相关。
在儿童期正常发育后,若在青春期出现如头痛加重、注意力不集中、头晕或步态障碍等症状,建议进行颅骨X线诊断。如果显示出颅内压慢性升高的征象,则需要进一步检查。