Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Neurosurg Rev. 2010 Apr;33(2):147-52; discussion 153. doi: 10.1007/s10143-010-0242-0. Epub 2010 Feb 23.
Hydrocephalus can be managed successfully with cerebrospinal fluid shunting to extracranial compartments, most commonly the peritoneum. However, current shunt systems are not ideal with high revision rates on long-term follow-up. Draining the cerebrospinal fluid from the cerebral ventricles to the cerebral venous sinuses could mimic the physiological conditions with the added advantages of avoiding overdrainage and extracranial recipient site complications. A literature search was carried out using the keywords hydrocephalus, shunt, venous sinus and sagittal sinus. Seven clinical series of ventriculosinus shunts with a total of 265 patients were found. None of the patients developed venous sinus thrombosis, air embolism or intra-operative sinus bleeding. Ventriculosinus shunt is a potential alternative that can be done under local anaesthetic in ill patients where traditional shunts recipient sites are not feasible. However, further studies with extended follow-up period would provide better understanding of the suitability and indications of this technique.
脑积水可以通过脑脊液分流到颅外腔室(最常见的是腹膜腔)来成功治疗。然而,目前的分流系统并不理想,长期随访的返修率很高。将脑脊液从脑室内引流到脑静脉窦可以模拟生理条件,同时避免过度引流和颅外受体部位并发症。使用关键词“脑积水”、“分流”、“静脉窦”和“矢状窦”进行了文献检索。共发现了 7 项脑室-静脉窦分流的临床系列研究,共有 265 例患者。没有患者发生静脉窦血栓形成、空气栓塞或术中窦出血。脑室-静脉窦分流术是一种潜在的替代方法,可以在局部麻醉下对病情较重的患者进行,这些患者传统的分流受体部位不可行。然而,进一步的研究需要延长随访时间,以便更好地了解该技术的适用性和适应证。