Bernard R, Vallee F, Mateo J, Marsella M, George B, Payen D, Chibbaro S
Neuro-ICU, Lariboisere University Hospital, Paris, France.
Minim Invasive Neurosurg. 2010 Oct;53(5-6):270-2. doi: 10.1055/s-0030-1269874. Epub 2011 Feb 7.
Endoscopic third ventriculostomy (ETV) is considered a safe procedure although it carries its rate of risks and complications that may occasionally be life-threatening.
This is a report about a 48-year-old woman presenting with progressive gait unsteadiness, weakness of the lower extremities and cognitive impairment due to tri-ventricular hydrocephalus. This was treated with standard ETV. In the immediate post-operative period the patient developed a severe and uncontrollable tachypnea requiring sedation, intubation and mechanical ventilation.
Tachypnea may be an early complication after standard ETV and although its mechanism remains yet unclear, we speculate that it may be related to excessive traction and/or surgical manipulation of the floor of the third ventricle. Supportive care with mechanical ventilation is the mainstay of treatment until spontaneous normalization of the respiratory mechanism occurs.
尽管内镜下第三脑室造瘘术（ETV）存在一定风险和并发症，偶尔可能危及生命，但仍被认为是一种安全的手术。
本文报告了一名48岁女性，因三脑室脑积水出现进行性步态不稳、下肢无力和认知障碍。采用标准ETV进行治疗。术后即刻，患者出现严重且难以控制的呼吸急促，需要镇静、插管和机械通气。
呼吸急促可能是标准ETV术后的早期并发症，尽管其机制尚不清楚，但我们推测可能与第三脑室底部过度牵拉和/或手术操作有关。在呼吸机制自发恢复正常之前，以机械通气为主的支持治疗是主要的治疗方法。
