Traynelis V C, Willison C D, Follett K A, Chambers J, Schochet S S, Kaufman H H
Department of Neurosurgery, Health Sciences Center, West Virginia University, Morgantown.
Neurosurgery. 1991 Jun;28(6):848-52. doi: 10.1097/00006123-199106000-00010.
Malfunctions of sterile shunts may result from valvular dysfunction. The cerebrospinal fluid shunt valves of 14 patients were excised during surgery for sterile shunt malfunctions. In 6 patients, the malfunction was due specifically to a valve malfunction. Cerebrospinal fluid from each valve was passed through a millipore filter, which was then stained using either hematoxylin and eosin or periodic acid-Schiff. The stained millipore filters were examined by a neuropathologist who was unaware of the cause of the shunt malfunction. Although inflammatory cells were detected in all cases, the patients with valve malfunctions were found to have numerous macrophages and giant multinucleated reactive cells within their valves, while cerebrospinal fluid from valves that had been removed during shunt revisions for reasons other than a malfunctioning valve contained only rare mononuclear cells or macrophages. No valve contained erythrocytes, fibrinous matter, neural or glial tissue, or choroid plexus. The possible causes of valve malfunction, including infection and allergic reactions, are discussed. All patients did well after simple replacement of the valve.
无菌分流器故障可能由瓣膜功能障碍引起。在因无菌分流器故障进行手术时，切除了14例患者的脑脊液分流瓣膜。其中6例患者的故障具体是由瓣膜功能障碍导致的。每个瓣膜的脑脊液通过微孔滤膜，然后用苏木精和伊红或过碘酸-希夫染色。由一位不知道分流器故障原因的神经病理学家检查染色后的微孔滤膜。虽然在所有病例中均检测到炎症细胞，但发现瓣膜功能障碍的患者瓣膜内有大量巨噬细胞和巨大的多核反应性细胞，而因分流器故障以外的原因在分流器翻修期间移除的瓣膜的脑脊液中仅含有罕见的单核细胞或巨噬细胞。没有瓣膜含有红细胞、纤维物质、神经或神经胶质组织或脉络丛。讨论了瓣膜功能障碍的可能原因，包括感染和过敏反应。所有患者在简单更换瓣膜后情况良好。
