Figaji A A, Fieggen A G, Peter J C
Division of Neurosurgery, School of Child and Adolescent Health, University of Cape Town, Red Cross War Memorial Childrens Hospital, Cape Town, South Africa.
Childs Nerv Syst. 2007 Jan;23(1):79-84. doi: 10.1007/s00381-006-0195-3. Epub 2006 Oct 13.
The role of endoscopy in hydrocephalus due to infectious aetiology is unclear. Tuberculous hydrocephalus is a useful model to study because it presents particular challenges and the pathophysiology of the cerebrospinal fluid disturbance is well known.
We present the results of 24 endoscopic operations in tuberculous meningitis.
Endoscopic third ventriculostomy (ETV) was attempted in 17 patients: seven were successful, five failed, and five were not completed due to abnormal anatomy. There were five fenestration procedures, three of which were successful. Endoscopic biopsy of two tuberculomas failed to yield a bacteriological result. These operations were more difficult to perform than for hydrocephalus due to other aetiologies.
Although ETV is technically possible in this situation, it is imperative that the patients are adequately selected for the procedure to ensure optimal treatment and that the surgeon has experience with difficult cases.
内镜检查在感染性病因导致的脑积水病例中的作用尚不清楚。结核性脑积水是一个值得研究的有用模型，因为它带来了特殊挑战，且脑脊液紊乱的病理生理学已为人熟知。
我们展示了24例结核性脑膜炎患者内镜手术的结果。
17例患者尝试了内镜下第三脑室造瘘术（ETV）：7例成功，5例失败，5例因解剖结构异常未完成。有5例开窗手术，其中3例成功。对两个结核瘤进行的内镜活检未获得细菌学结果。这些手术比因其他病因导致的脑积水手术更难实施。
虽然在这种情况下ETV在技术上可行，但必须对患者进行充分筛选以确保最佳治疗效果，并且外科医生要有处理疑难病例的经验。
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