Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Wonmi-gu, Bucheon, Korea.
J Korean Med Sci. 2010 Apr;25(4):647-50. doi: 10.3346/jkms.2010.25.4.647. Epub 2010 Mar 19.
Shunt malfunctions that require surgical intervention during pregnancy and the postpartum period are rare. Furthermore, no study has reported on an acute shunt malfunction immediately after cesarean section. Here, we describe the case of a 32-yr-old woman who became drowsy 12 hr after cesarean section delivery of her second child. She had a ventriculoperitoneal shunt placed to treat hydrocephalus associated with meningitis at 26 yr of age. Marked ventriculomegaly was seen on brain computed tomography and her consciousness recovered temporarily after aspirating cerebrospinal fluid from the flushing device. At surgery, the distal catheter tip was plugged by a blood clot. We believe that the blood spilled over during the cesarean section. The clogged catheter end was simply cut off and the remaining catheter was repositioned in the peritoneal cavity. Her consciousness recovered fully.
在怀孕期间和产后需要手术干预的分流故障很少见。此外,尚无研究报道剖宫产术后立即出现急性分流故障。在这里,我们描述了一位 32 岁女性的病例,她在第二次剖宫产分娩后 12 小时变得昏昏欲睡。她在 26 岁时因脑膜炎并发脑积水接受了脑室-腹腔分流术。脑计算机断层扫描显示明显的脑室扩大,从冲洗装置抽吸脑脊液后她的意识暂时恢复。手术时,远端导管尖端被血凝块堵塞。我们认为这是剖宫产术中出血所致。堵塞的导管末端被简单地切断,剩余的导管重新放置在腹腔内。她的意识完全恢复。