Lee Ching-Yi, Wu Chieh-Tsai, Lin Kuang-Lin, Hsu Hsun-Hui
Department of Neurosurgery, Chang Gung University Colleage of Medicine, Taoyuan, Taiwan.
Acta Neurol Taiwan. 2011 Sep;20(3):197-201.
Ventriculoperitoneal (VP) shunt or ventriculoatrial shunt is a common operation for treatment of hydrocephalus. Usually, shunt series (plain radiographs of the skull, neck, chest and abdomen) and brain computed tomography (CT) are used to monitor the status of hydrocephalus and VP shunt. However, does the result of a brain CT really reflect the status of the hydrocephalus and shunt function? In patients with VP shunt, brain CT image only may lead to misdiagnosis of the status of the hydrocephalus and result in inadequate treatment plan.
The authors reported a 6-year-old patient with occult cerebrospinal fluid (CSF) fistula between ventricle and extra-ventricular position of the VP shunt tip on CT scan and resulted in inappropriate shunt removal.
The patient was diagnosed to have shunt-dependent hydrocephalus with inadequate shunt removal. In this kind of patient, further studies may reduce unnecessary morbidity or mortality.
脑室腹腔（VP）分流术或脑室心房分流术是治疗脑积水的常见手术。通常，分流系列检查（头颅、颈部、胸部和腹部的X线平片）和脑部计算机断层扫描（CT）用于监测脑积水和VP分流的状况。然而，脑部CT的结果真的能反映脑积水的状况和分流功能吗？在VP分流患者中，仅脑部CT图像可能会导致对脑积水状况的误诊，并导致治疗方案不充分。
作者报告了一名6岁患者，其VP分流管尖端在脑室与脑室外位置之间存在隐匿性脑脊液（CSF）瘘，CT扫描显示导致了不适当的分流管移除。
该患者被诊断为依赖分流的脑积水且分流管移除不充分。对于这类患者，进一步的研究可能会降低不必要的发病率或死亡率。
