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脑脊液分流功能障碍伴四肢瘫痪的脊髓空洞症:病例说明

Syringomyelia with quadriparesis in CSF shunt malfunction: a case illustration.

作者信息

Martínez-Lage Juan F, Alarcón Fernando, López López-Guerrero Antonio, Felipe-Murcia Matías, Ruíz-Espejo Vilar Antonio, Almagro María-José

机构信息

Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain.

出版信息

Childs Nerv Syst. 2010 Sep;26(9):1229-31. doi: 10.1007/s00381-010-1165-3. Epub 2010 May 6.

DOI:10.1007/s00381-010-1165-3
PMID:20445982
Abstract

BACKGROUND

Shunt malfunction typically presents with headaches, vomiting, and impaired consciousness. Paraparesis has been rarely reported as the initial manifestation of valve dysfunction.

CASE ILLUSTRATION

A 17-year-old boy was admitted with invalidating quadriparesis that after neuroimaging evaluation was found to be produced by communicating syringomyelia attributed to shunt malfunction.

DISCUSSION AND CONCLUSION

Persistence of the central canal in association with communicating hydrocephalus may lead to the development of communicating syringomyelia. In this context, insufficient drainage of CSF produced by shunt dysfunction may evolve exclusively with symptoms and signs of spinal cord involvement in the absence of the usual cerebral manifestations related to shunt failure.

摘要

背景

分流器故障通常表现为头痛、呕吐和意识障碍。截瘫作为瓣膜功能障碍的初始表现鲜有报道。

病例说明

一名17岁男孩因四肢瘫入院,经神经影像学评估发现是由分流器故障导致的交通性脊髓空洞症引起的。

讨论与结论

中央管持续存在并伴有交通性脑积水可能导致交通性脊髓空洞症的发生。在这种情况下,分流器功能障碍导致的脑脊液引流不足可能仅表现为脊髓受累的症状和体征,而无通常与分流器故障相关的脑部表现。

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本文引用的文献

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Ventriculoperitoneal shunt malfunction presenting as acute paraparesis in an infant.脑室腹腔分流术故障表现为婴儿急性双下肢轻瘫。
J Neurosurg Pediatr. 2010 Apr;5(4):402. doi: 10.3171/2009.10.PEDS09191.
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Classification of syringomyelia.脊髓空洞症的分类。
Neurosurg Focus. 2000 Mar 15;8(3):E1. doi: 10.3171/foc.2000.8.3.1.
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Paraparesis secondary to expansion of cervical syrinx: an unusual presentation of ventriculo-peritoneal shunt malfunction.颈髓空洞症扩张继发的双下肢轻瘫:脑室-腹腔分流术故障的一种罕见表现。
经脑脊液动力学研究证实与脑室腹腔分流术故障相关的交通性脊髓空洞症:病例报告
Childs Nerv Syst. 2013 Oct;29(10):1953-5. doi: 10.1007/s00381-013-2133-5. Epub 2013 May 8.
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Syringomyelia secondary to shunt malfunction.
Childs Nerv Syst. 2010 Nov;26(11):1487-8; author reply 1489. doi: 10.1007/s00381-010-1246-3. Epub 2010 Aug 10.
Pediatr Neurosurg. 2005 Nov-Dec;41(6):334-6. doi: 10.1159/000088737.
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Acute syringomyelia: case report.急性脊髓空洞症:病例报告
Neurosurgery. 2003 Nov;53(5):1220-1; discussion 1221-2. doi: 10.1227/01.neu.0000088809.14965.00.
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Transient oedema of the cervical spinal cord.颈髓短暂性水肿
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Unique clinical presentation of pediatric shunt malfunction.小儿分流器故障的独特临床表现。
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