Rahman Mohammed Izad, Raveendran Savitha, Kaliaperumal Chandrasekaran, Marks Charles
Department of Neurological Surgery, Cork University Hospital, Wilton, Republic of Ireland.
J Nat Sci Biol Med. 2012 Jan;3(1):105-7. doi: 10.4103/0976-9668.95987.
We describe a case of pseudotumor cerebri in a young man developing 4 years post-traumatic brain injury (TBI). A 29-year-old man was admitted after sustaining a fall with headache, and no clinical deficits were noted on examination. CT brain demonstrated an extradural hematoma. This was successfully evacuated after his symptomatic worsening. Following this, he developed bone flap infection and had the infected bone flap removed. He developed chronic mild-to-moderate headache following these procedures, which failed to respond to medical treatment. Pseudotumor cerebri was diagnosed. A lumboperitoneal (LP) shunt, ventriculo-peritoneal (VP) shunt, and bitemporal craniectomy were performed as a part of management at different stages. Post-TBI patients may present with chronic headache and in such circumstances, a possibility of pseudotumor cerebri must be considered. Investigations should include neuroimaging in the form of MRI/MRV and fundoscopy to look for papilledema. Management in the form of CSF flow diversion techniques (VP and LP shunt) with medical management results in good clinical outcomes.
我们描述了一例年轻男性在创伤性脑损伤（TBI）4年后发生的假性脑瘤病例。一名29岁男性因跌倒后头痛入院，检查时未发现临床缺陷。脑部CT显示硬膜外血肿。在其症状恶化后，成功进行了血肿清除术。此后，他发生了骨瓣感染，并切除了感染的骨瓣。在这些手术后，他出现了慢性轻至中度头痛，药物治疗无效。诊断为假性脑瘤。作为不同阶段治疗的一部分，进行了腰大池-腹腔（LP）分流术、脑室-腹腔（VP）分流术和双侧颞部颅骨切除术。创伤性脑损伤后的患者可能会出现慢性头痛，在这种情况下，必须考虑假性脑瘤的可能性。检查应包括以MRI/MRV形式进行的神经影像学检查和眼底镜检查以寻找视乳头水肿。采用脑脊液引流技术（VP和LP分流术）并结合药物治疗可取得良好的临床效果。
