Humphries William E, Grossi Peter M, Liethe Linda G, George Timothy M
Pediatric Neurosurgery Service, Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
J Neurosurg Spine. 2007 Jan;6(1):60-3. doi: 10.3171/spi.2007.6.1.60.
The authors describe the case of a 36-year-old woman with bilateral internal jugular vein occlusion, hydrocephalus, and Dandy-Walker variant who presented with myelopathy that was ultimately attributed to ventriculoperitoneal (VP) shunt failure. Computed tomography (CT) angiography of the head and neck revealed epidural venous engorgement within the cervical spine, greater that 50% narrowing of the C2-5 spinal canal, and compression of the cervical spinal cord. After successful shunt revision, postoperative CT angiography revealed decreased venous engorgement as well as decompression of the cervical spinal cord, and the patient's myelopathy improved. This case represents a fascinating clinical presentation of VP shunt failure, highlighting the physiological importance of the external jugular pathways involved in cerebral venous drainage.
作者描述了一名36岁女性的病例，该患者患有双侧颈内静脉闭塞、脑积水和Dandy-Walker变异型，表现为脊髓病，最终归因于脑室腹腔（VP）分流失败。头颈部计算机断层扫描（CT）血管造影显示颈椎内硬膜外静脉充血，C2-5椎管狭窄超过50%，颈脊髓受压。成功进行分流修复术后，术后CT血管造影显示静脉充血减轻以及颈脊髓减压，患者的脊髓病得到改善。该病例代表了VP分流失败的一种引人关注的临床表现，突出了参与脑静脉引流的颈外静脉途径的生理重要性。
