Doorenbosch X, Molloy C J, David D J, Santoreneos S, Anderson P J
Department of Neurosurgery, Women's and Children's Hospital, 72 King William Rd, North Adelaide, South Australia, 5006, Australia.
Childs Nerv Syst. 2009 Jul;25(7):871-4. doi: 10.1007/s00381-009-0842-6. Epub 2009 Feb 27.
Ventricular shunt-induced craniosynostosis is a widely recognised cause of secondary craniosynostosis. We reviewed the management and long-term outcome of the cases of cranial deformity post cerebrospinal fluid shunting in our unit and compared these with previously published series.
The Australian Craniofacial Unit and Department of Neurosurgery database was searched to identify cases of ventricular shunt-induced cranial deformity and a case note review was undertaken.
Eight cases were identified, and all were shunted within 6 months of birth. Our patients required shunting with a low pressure valve for hydrocephalus secondary to either aqueduct stenosis or intraventricular haemorrhage. The diagnosis was made following computed tomography (CT) three-dimensional surface reconstruction of the skull. Two cases of confirmed suture fusion were treated with cranial vault remodelling and programmable shunt insertion. In six cases, the sutures were not completely fused on the CT images despite a scaphocephalic head shape. These patients were managed conservatively with close monitoring.
Cranial vault remodelling together with insertion of programmable shunt valve is indicated in CT confirmed cases of secondary craniosynostosis.
脑室分流术所致颅骨缝早闭是继发性颅骨缝早闭的一个广泛认可的病因。我们回顾了本单位脑脊液分流术后颅骨畸形病例的治疗及长期预后情况，并与既往发表的系列研究进行比较。
检索澳大利亚颅面外科中心和神经外科数据库，以确定脑室分流术所致颅骨畸形病例，并进行病例记录回顾。
共识别出8例病例，均在出生后6个月内接受了分流术。我们的患者因导水管狭窄或脑室内出血继发脑积水而需要使用低压阀进行分流。诊断通过颅骨计算机断层扫描（CT）三维表面重建做出。2例确诊缝线融合的病例接受了颅骨重塑和可编程分流器植入治疗。6例患者尽管头颅呈舟状头型，但CT图像上缝线未完全融合。这些患者接受密切监测的保守治疗。
对于CT确诊的继发性颅骨缝早闭病例，应进行颅骨重塑并植入可编程分流阀。
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