Seyıthanoglu Hakan, Guzey Feyza Karagoz, Emel Erhan, Ozkan Nezih, Aycan Abdurrahman
Vakıf Gureba Education Hospital Department of Neurosurgery Istanbul, Turkey.
Turk Neurosurg. 2010 Oct;20(4):519-23. doi: 10.5137/1019-5149.JTN.2231-09.1.
Chronic calcified/ossified epidural hematoma is an uncommon complication of ventricular shunt surgery. There are only 4 cases related to valve-regulated shunt operations in the literature. It may be seen especially in young patients with chronic hydrocephalus, probably due to craniocerebral disproportion. The precise mechanism of the calcification or ossification of the hematoma is not known, however, the dura mater seems to play a part in this process. A 17-year-old girl with triventricular hydrocephalus was treated with a ventriculoperitoneal shunt system including a medium pressure flow control valve. She was admitted with a complaint of severe headache after three years and a bifrontal calcified/ossified epidural hematoma was seen. The calcifying hematoma was removed and the patient's headache resolved. Although the use of high or medium pressure valves, valves with an antisiphon device, adjustable pressure valves or flow control valves have been recommended to prevent this complication in previous reports, it was seen that our case had been treated with a medium pressure flow control valve.
慢性钙化/骨化性硬膜外血肿是脑室分流手术罕见的并发症。文献中仅有4例与瓣膜调节分流手术相关。尤其在患有慢性脑积水的年轻患者中可能出现,这可能是由于颅脑比例失调所致。然而,血肿钙化或骨化的确切机制尚不清楚,不过硬脑膜似乎在此过程中起了一定作用。一名患有三脑室脑积水的17岁女孩接受了包括中压流量控制阀的脑室腹腔分流系统治疗。三年后,她因严重头痛入院,检查发现双侧额叶有钙化/骨化性硬膜外血肿。钙化血肿被清除,患者头痛症状缓解。尽管之前的报告建议使用高压或中压瓣膜、带有防虹吸装置的瓣膜、可调压力瓣膜或流量控制阀来预防这种并发症,但我们的病例使用的是中压流量控制阀。