Kimura Toshikazu, Tsutsumi Kazuo, Morita Akio
Department of Neurosurgery and Stroke Unit, NTT Medical Center Tokyo, Tokyo, Japan.
Neurol Med Chir (Tokyo). 2011;51(12):861-2. doi: 10.2176/nmc.51.861.
A 57-year-old man presented with recurrent parasagittal anaplastic meningioma of frontoparietal region. The tumor was extensively removed, and the dura was repaired with Gore-Tex surgical membrane. After the operation, subcutaneous cerebrospinal fluid (CSF) collection was observed in the fronto-parietal area and a lumboperitoneal shunt was placed. Four weeks after the shunt procedure, he complained of right scrotal swelling and recurrence of the CSF collection. Radiography revealed the coiled catheter in the scrotum. The catheter was surgically removed through a small incision in the skin of the scrotum under local anesthesia. Lumboperitoneal shunt is a simple and useful procedure to control CSF pressure, but catheter migration has been reported in infants and children. Shunt catheter can migrate into the scrotum even in an adult, as the vaginal process, through which the catheter seemed to have entered the scrotum, is patent in 5% of the adult population. In these cases, direct removal through a small incision is appropriate to remove the catheter.
一名57岁男性因额顶叶区域复发性矢状窦旁间变性脑膜瘤前来就诊。肿瘤被广泛切除,硬脑膜用戈尔特斯外科膜修复。术后,在额顶叶区域观察到皮下脑脊液(CSF)聚集,并进行了腰大池腹腔分流术。分流术后四周,他抱怨右侧阴囊肿胀且脑脊液聚集复发。影像学检查显示阴囊内有盘绕的导管。在局部麻醉下通过阴囊皮肤的小切口手术取出导管。腰大池腹腔分流术是控制脑脊液压力的一种简单且有用的方法,但已有报道称在婴儿和儿童中会发生导管移位。即使在成年人中,分流导管也可能移入阴囊,因为导管似乎通过其进入阴囊的鞘突在5%的成年人群中是通畅的。在这些情况下,通过小切口直接取出导管以移除导管是合适的。