Sun Hui, Tian Hengli
Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Neurologist. 2011 Nov;17(6):342-5. doi: 10.1097/NRL.0b013e318235c617.
Intraspinal tumor accompanied by hydrocephalus is an unusual but well-documented condition. Although many authors have proposed a variety of possible causes, the etiology is still unknown. Meanwhile, little has been discussed about the treatment strategy.
We report a case of intraspinal neurinoma accompanied by hydrocephalus. The patient presented with numbness and weakness of the legs, incontinence, and headache. Computed tomography scan demonstrated hydrocephalus and obvious peri-ventricular edema. She was given ventriculoperitoneal (V-P) shunt, but the shunt system had to be removed due to a postoperative intracranial hematoma. To our surprise, the hydrocephalus resolved after the tumor resection. We reviewed the literature and discussed a reasonable treatment strategy for this condition.
In patients presenting with hydrocephalus of unclear etiology, attention should be paid to possible spine pathology. If an intraspinal neurinoma is found, a V-P shunt is usually not necessary. A V-P shunt is only indicated when hydrocephalus does not improve after tumor resection.
脊髓内肿瘤伴脑积水是一种不常见但有充分文献记载的病症。尽管许多作者提出了多种可能的病因,但病因仍不明。同时,关于治疗策略的讨论很少。
我们报告一例脊髓神经鞘瘤伴脑积水的病例。患者表现为腿部麻木、无力、大小便失禁和头痛。计算机断层扫描显示脑积水和明显的脑室周围水肿。她接受了脑室腹腔(V-P)分流术,但由于术后颅内血肿,分流系统不得不被移除。令我们惊讶的是,肿瘤切除后脑积水得到缓解。我们回顾了文献并讨论了针对这种情况的合理治疗策略。
对于病因不明的脑积水患者,应注意可能的脊柱病变。如果发现脊髓神经鞘瘤,通常不需要进行V-P分流术。只有在肿瘤切除后脑积水没有改善时才考虑进行V-P分流术。