Gold Menachem M, Shifteh Keivan, Valdberg Stella, Lombard Jay, Lipton Michael L
Department of Radiology, Montefiore Medical Center Bronx, 111 East 210th Street, Bronx, NY 10467, USA.
Neurologist. 2008 Jul;14(4):252-4. doi: 10.1097/NRL.0b013e31816b73e4.
Infection and hemorrhage are well-known complications from insertion of intracranial shunts. However, permanent injury to the brain caused by catheterization of the cerebral ventricles has rarely been reported.
We report a patient who presented at age 14 years for evaluation of a severe behavioral disorder. The patient had sustained direct injury to the corticospinal tract and limbic system during revision of a ventriculoperitoneal shunt at the age of 9 years.
Despite persistent evidence of severe disruption of the corticospinal tract on diffusion tensor imaging at age 14 years, the patient had regained complete motor function.
Recovery of motor function after serious injury to motor cortex during childhood is a dramatic example of the plasticity of the child's brain to injury. In addition, we suggest that the behavioral disorder that emerged in this patient may be related to limbic system injury suffered during the shunt revision.
感染和出血是颅内分流管插入术常见的并发症。然而，脑室插管导致的永久性脑损伤鲜有报道。
我们报告一名14岁因严重行为障碍前来评估的患者。该患者在9岁时进行脑室腹腔分流管翻修术时，皮质脊髓束和边缘系统受到直接损伤。
尽管在14岁时的扩散张量成像中仍有严重皮质脊髓束中断的证据，但该患者已恢复完全运动功能。
儿童期运动皮层严重损伤后运动功能的恢复是儿童大脑对损伤可塑性的一个显著例子。此外，我们认为该患者出现的行为障碍可能与分流管翻修术期间遭受的边缘系统损伤有关。
