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[破裂的前交通动脉瘤治疗后迟发性慢性脑积水导致手术夹移位致前视路受压]

[Anterior optic pathways compression by a surgical clip mobilized by delayed chronic hydrocephalus after treatment of a ruptured anterior communicating artery aneurysm].

作者信息

Zaïri F, Thines L, Bourgeois P, Ayachi M, Lejeune J-P

机构信息

Pôle de neurochirurgie, hôpital Roger-Salengro, CHU de Lille, rue Emile-Laine, 59000 Lille, France.

出版信息

Neurochirurgie. 2012 Feb;58(1):34-6. doi: 10.1016/j.neuchi.2011.07.006. Epub 2011 Oct 10.

Abstract

Chronic hydrocephalus is a classic and recognized complication that affects 6 to 37% of patients with aneurysmal subarachnoid haemorrhage. The diagnosis is often mentioned due to the delayed onset of gait disturbance and slower psychomotor performance. The CT-scan confirms the diagnosis by showing an enlargement of the ventricles. In case of symptomatic hydrocephalus, a ventriculo-peritoneal shunt is often required. The authors report a rare case of chronic hydrocephalus presenting with visual symptoms, due to the delayed mobilisation of a surgical clip with direct mass effect over the anterior optic pathways. The treatment of hydrocephalus led to a rapid and complete regression of symptoms.

摘要

慢性脑积水是一种经典且公认的并发症,影响6%至37%的动脉瘤性蛛网膜下腔出血患者。由于步态障碍出现延迟和精神运动表现较慢,常提及该诊断。CT扫描通过显示脑室扩大来确诊。对于有症状的脑积水,通常需要进行脑室-腹腔分流术。作者报告了一例罕见的慢性脑积水病例,该病例因手术夹移位延迟对视神经前通路产生直接占位效应而出现视觉症状。脑积水的治疗使症状迅速且完全消退。

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