Department of Neurosurgery, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Acta Neurochir (Wien). 2010 Apr;152(4):713-6. doi: 10.1007/s00701-009-0470-7. Epub 2009 Jul 29.
A newly-born infant with a congenital dural and bony defect and an associated short-segmented duplication of the superior sagittal sinus suffered from herniation and infarction of parietal brain tissue secondary to vacuum extraction. This ultimately led to the formation of a subgaleal cerebrospinal fluid (CSF) collection. Initial operative closure of the encephalocele was performed by attaching a galeal flap to the periostium surrounding the congenital defect. As the bony defect developed characteristics of a growing fracture later on, dural repair, transplantation of a split-bone flap and, finally, the insertion of a ventriculoperitoneal shunt became necessary. This case affirms that stringent indication and cautious usage of vacuum-assisted delivery is strongly recommended, especially in view of the possibility that undetected congenital cranial, vascular and/or cerebral alterations may be present.
一个新生儿患有先天性硬脑膜和骨缺损，并伴有矢状窦上段短节段重复，因真空吸引而发生脑疝和顶叶脑组织梗死。这最终导致了帽状腱膜下脑脊液（CSF）积聚。最初通过将头皮瓣附着在先天性缺陷周围的骨膜上来进行脑膜膨出的手术闭合。随着骨缺损后来发展为生长性骨折的特征，需要进行硬脑膜修复、骨瓣劈开移植，最终还需要插入脑室-腹腔分流管。本病例证实，强烈建议严格掌握适应证并谨慎使用真空辅助分娩，特别是因为可能存在未被发现的先天性颅、血管和/或脑异常。
