内镜下取出迁移至第三脑室导致脑积水的子弹。
Endoscopic Removal of a Bullet That Migrated to the Third Ventricle Causing Hydrocephalus.
作者信息
Aydoseli Aydın, Unal Tugrul Cem, Aras Yavuz, Sabanci Pulat Akın, Altunrende Emre, Izgi Nail
机构信息
Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Department of Neurosurgery, Tunceli State Hospital, Tunceli, Turkey.
出版信息
World Neurosurg. 2017 Sep;105:1038.e11-1038.e16. doi: 10.1016/j.wneu.2017.06.078. Epub 2017 Jun 20.
BACKGROUND
Hydrocephalus caused by an intraventricular bullet is a rare event. We report a case of endoscopic removal of an intraventricular bullet.
CASE DESCRIPTION
A 66-year-old man was admitted with a gunshot wound to the head after a suicide attempt. The bullet migrated from the frontal parenchyma to the third ventricle day 4 of admission. On day 21 of admission, the patient developed hydrocephalus with obstruction of the cerebral aqueduct. The bullet was accessed through an endoscopic third ventriculostomy and removed using an endoscope.
CONCLUSIONS
Hydrocephalus may develop in patients with intraventricular foreign objects. When such objects must be removed, the endoscopic approach is a safe, efficient, and minimally invasive procedure. To our knowledge, this is the first case in the literature of foreign object removal from the ventricle via a transcortical endoscopic approach.
背景
脑室内子弹导致的脑积水是一种罕见情况。我们报告一例经内镜取出脑室内子弹的病例。
病例描述
一名66岁男性因自杀未遂头部遭受枪伤入院。入院第4天，子弹从额叶实质移至第三脑室。入院第21天，患者出现脑积水伴中脑导水管梗阻。通过内镜下第三脑室造瘘术找到子弹，并使用内镜将其取出。
结论
脑室内有异物的患者可能会发生脑积水。当必须取出此类异物时，内镜手术是一种安全、有效且微创的方法。据我们所知，这是文献中首例经皮质内镜途径从脑室内取出异物的病例。
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