Matsumoto Masaki, Takai Keisuke, Taniguchi Makoto
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, Tokyo, 183-0042, Japan.
Childs Nerv Syst. 2013 Oct;29(10):1953-5. doi: 10.1007/s00381-013-2133-5. Epub 2013 May 8.
A 20-year-old male presented with neck pain and motor impairment of the upper extremities because of recurrent syringomyelia caused by ventriculoperitoneal shunt malfunction.
A computed tomography scan after shuntgraphy demonstrated opacity in the intracranial ventricular system and cervical syrinx with contrast medium, which indicated communication between the fourth ventricle and syrinx. His symptoms resolved immediately after peritoneal catheter replacement, and magnetic resonance images obtained 1 week after surgery showed the complete resolution of hydrocephalus and syringomyelia.
Syringomyelia associated with ventriculoparitoneal shunt malfunction is a well-known complication in myelodysplastic patients; however, this is the first case in which communicating syringomyelia was verified with a cerebrospinal fluid dynamic study. As the present case involved communicating syringomyelia, it could only be resolved by shunt revision surgery.
一名20岁男性因脑室腹腔分流术故障导致反复出现脊髓空洞症,出现颈部疼痛和上肢运动障碍。
分流造影后的计算机断层扫描显示颅内脑室系统和颈段脊髓空洞内有造影剂充盈缺损,提示第四脑室与脊髓空洞相通。更换腹腔导管后,他的症状立即缓解,术后1周获得的磁共振图像显示脑积水和脊髓空洞症完全消退。
与脑室腹腔分流术故障相关的脊髓空洞症是脊髓发育不良患者中一种众所周知的并发症;然而,这是第一例通过脑脊液动力学研究证实为交通性脊髓空洞症的病例。由于本病例涉及交通性脊髓空洞症,只能通过分流修复手术解决。