Morina Dukagjin, Petridis Athanasios K, Fritzsche Friederike S, Ntoulias Georgios, Scholz Martin
Department of Neurosurgery, Wedau Kliniken Duisburg , Germany.
Clin Pract. 2013 Jan 30;3(1):e1. doi: 10.4081/cp.2013.e1. eCollection 2013 Jan 25.
We describe a case of progressive syringomyelia following post-infectious trapped fourth ventricle (TFV), which resolved after shunting of the fourth ventricle. A 28-year-old female who had previously undergone treatment of intracerebral hemorrhage and meningitis developed a hydrocephalus with TFV. After 3 years she developed disturbance of walking and coordination. Cranial-CT revealed an enlargement of the shunted fourth ventricle as a result of shunt dysfunction. Furthermore a cervical syringomyelia developed. The patient underwent a revision of a failed fourth ventriculo-peritoneal shunt. Postoperatively, syringomyelia resolved within 6 months and the associated neurological deficits improved significantly. An insufficiency of cerebrospinal fluid draining among patients with TFV can be associated with communicating syringomyelia. An early detection and treatment seems important on resolving syringomyelia and avoiding permanent neurological deficits. Ventriculo-peritoneal shunt in trapped fourth ventricles can resolve a secondary syringomyelia.
我们描述了一例感染后第四脑室受压（TFV）继发进行性脊髓空洞症的病例，该病例在第四脑室分流术后得到缓解。一名28岁女性，既往有脑出血和脑膜炎病史，随后出现伴有TFV的脑积水。3年后，她出现行走和协调障碍。头颅CT显示，由于分流功能障碍，已分流的第四脑室扩大。此外，还出现了颈段脊髓空洞症。患者接受了失败的第四脑室-腹腔分流术的翻修手术。术后，脊髓空洞症在6个月内消失，相关神经功能缺损明显改善。TFV患者脑脊液引流不足可能与交通性脊髓空洞症有关。早期发现和治疗对于解决脊髓空洞症和避免永久性神经功能缺损似乎很重要。第四脑室受压时进行脑室-腹腔分流术可解决继发性脊髓空洞症。
