Pinto Fernando Campos Gomes, Pereira Renan Muralho, Saad Felippe, Teixeira Manoel Jacobsen
Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo (USP), São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2012 Sep;70(9):704-9. doi: 10.1590/s0004-282x2012000900011.
Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA(®) in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H(2)O after tap test (40 mL), 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT) evidence of hypo or overdrainage, and no immediate early or late significant complications.
患有脑积水且存在引流过度风险因素的患者可能需要植入带有抗虹吸装置的脑室分流器(VS)。本研究的目的是对35例患有脑积水且存在引流过度风险因素的成年患者,前瞻性地评估使用抗虹吸装置SPHERA(®)的定压阀植入术的临床和断层扫描结果,为期两年。其中,3例成年先天性脑积水患者脑室极度扩张(埃文斯指数>50%),3例先前VS植入术后出现有症状的引流过度(硬膜下血肿、脑脊膜囊肿或裂隙脑室综合征),1例曾有慢性硬膜下血肿,15例正常压力脑积水患者在腰穿试验(40 mL)后腰终压<5 cm H₂O,6例有假性脑瘤,7例因其他原因导致脑积水。在两年期间,94.3%的患者临床症状得到改善且持续存在,计算机断层扫描(CT)未显示引流不足或过度的证据,也未出现即刻的早期或晚期严重并发症。