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[腰大池-腹腔分流术治疗良性颅内高压的罕见并发症]

[Unusual complications of the lumboperitoneal shunt as treatment of benign intracranial hypertension].

作者信息

Castillo L, Bermejo P E, Zabala J A

机构信息

Servicio de Neurología, Hospital Universitario Puerta de Hierro, Madrid.

出版信息

Neurologia. 2008 Apr;23(3):192-6.

Abstract

INTRODUCTION

Intracranial hypertension is a picture characterized by elevated cerebrospinal fluid pressure that may cause some different complications including optic disc edema and visual accuracy alterations. Although treatment is generally pharmacological, invasive therapeutical techniques such as optic nerve sheath fenestration and lumboperitoneal shunt are sometimes required. The latter one is a technique that usually provides good results with a low complication rate, including infections, mechanical failure and overdrainage.

CASE REPORT

We report the case of a 40 year-old female patient with an idiopathic intracranial hypertension picture who required a lumboperitoneal shunt due to her progressive deterioration. After a few hours, the patient developed an intracerebral hematoma and subarachnoid hemorrhage, and some days later she developed a venous sinus thrombosis. These two complications, although described in the literature, are very unusual.

CONCLUSIONS

Even though the lumboperitoneal shunt is a safe technique with good results, it is not exempt from complications. We alert about the need to take into account subarachnoid hemorrhage and venous sinus thrombosis as possible complications in the followup of these patients.

摘要

引言

颅内高压是一种以脑脊液压力升高为特征的病症,可能会引发一些不同的并发症,包括视盘水肿和视力改变。尽管治疗通常采用药物治疗,但有时也需要采用视神经鞘开窗术和腰大池腹腔分流术等侵入性治疗技术。后者是一种通常能取得良好效果且并发症发生率较低的技术,并发症包括感染、机械故障和引流过度。

病例报告

我们报告了一例40岁女性特发性颅内高压患者的病例,该患者因病情逐渐恶化而需要进行腰大池腹腔分流术。术后数小时,患者出现脑内血肿和蛛网膜下腔出血,几天后又出现静脉窦血栓形成。这两种并发症虽然在文献中有描述,但非常罕见。

结论

尽管腰大池腹腔分流术是一种安全且效果良好的技术,但仍不免会出现并发症。我们提醒,在对这些患者进行随访时,需要考虑到蛛网膜下腔出血和静脉窦血栓形成这两种可能的并发症。

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