Chiari I型减压术后的症状性硬膜下积液和脑积水
Symptomatic Subdural Hygroma and Hydrocephalus following Chiari I Decompression.
作者信息
Filis Andreas K, Moon Karam, Cohen Alan R
机构信息
Division of Pediatric Neurosurgery, Rainbow Babies and Children's Hospital, The Neurological Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
出版信息
Pediatr Neurosurg. 2009;45(6):425-8. doi: 10.1159/000270159. Epub 2009 Dec 24.
BACKGROUND
The aim of the present case report is to describe an unusual complication of foramen magnum decompression (FMD) for the Chiari 1 hindbrain malformation and its successful management with non-operative measures.
METHODS
A 2-year-old girl with the Chiari 1 malformation underwent FMD, including suboccipital craniotomy, C1 laminectomy and durotomy without opening the arachnoid.
RESULTS
After initial postoperative improvement, the patient deteriorated, developing subdural hygromas and hydrocephalus. These were treated successfully with observation and acetazolamide.
CONCLUSIONS
Subdural hygromas may complicate FMD. A slit valve opening in the arachnoid might be part of the pathophysiology. While surgical intervention may be necessary in some circumstances, non-operative measures may be effective as well.
背景
本病例报告旨在描述枕大孔减压术（FMD）治疗Chiari 1型后脑畸形的一种罕见并发症，以及采用非手术措施成功处理该并发症的情况。
方法
一名患有Chiari 1型畸形的2岁女孩接受了枕大孔减压术，包括枕下开颅术、C1椎板切除术和硬脑膜切开术，但未打开蛛网膜。
结果
术后初期病情改善后，患者病情恶化，出现硬膜下积液和脑积水。通过观察和使用乙酰唑胺成功治疗了这些病症。
结论
硬膜下积液可能是枕大孔减压术的并发症。蛛网膜上的裂隙瓣膜开口可能是病理生理学的一部分。虽然在某些情况下可能需要手术干预，但非手术措施也可能有效。
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