Pendleton Courtney, Zaidi Hasan A, Jallo George, Cohen-Gadol Aaron A, Quiñones-Hinojosa Alfredo
Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21231, USA.
J Neurosurg Pediatr. 2010 May;5(5):423-7. doi: 10.3171/2009.12.PEDS09388.
A review of the Johns Hopkins Hospital surgical records from 1896 to 1912 revealed a case from 1908 wherein Dr. Harvey Cushing attempted to treat hydrocephalus in a 4-month-old infant by constructing a shunt for which he used a venous segment harvested from the patient's father. Prior to this procedure, surgeons used shunts constructed from various often highly immunogenic materials. In addition to addressing the limitations of these materials, Cushing's technique allowed the inclusion of valves within the shunt, preventing the retrograde flow of CSF. Despite the success of this procedure in canine models, the child's postoperative death prevented an assessment of its success in a human. It is possible that Cushing's approach would meet with more success today, given the modern benefits of human leukocyte antigen tissue typing and immunosuppressant agents.
对约翰霍普金斯医院1896年至1912年手术记录的回顾发现了1908年的一个病例,当时哈维·库欣医生试图通过构建分流管来治疗一名4个月大婴儿的脑积水,他使用了从患儿父亲身上采集的一段静脉。在此手术之前,外科医生使用的分流管由各种通常具有高度免疫原性的材料制成。除了解决这些材料的局限性外,库欣的技术还允许在分流管中加入瓣膜,防止脑脊液逆流。尽管该手术在犬类模型中取得了成功,但患儿术后死亡,无法评估其在人体中的成功情况。鉴于人类白细胞抗原组织分型和免疫抑制剂的现代优势,库欣的方法如今有可能取得更大成功。