Ayvalık Fatih, Ozay Rafet, Turkoglu Erhan, Balkan Mehmet Serdar, Şekerci Zeki
Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Surg J (N Y). 2016 Dec 1;2(4):e139-e142. doi: 10.1055/s-0036-1594245. eCollection 2016 Oct.
Idiopathic intracranial hypertension is characterized by high intracranial pressure without hydrocephalus or intracranial mass. Surgical treatment includes optic nerve fenestration and insertion of ventriculoperitoneal and lumboperitoneal (LP) shunts. For decreasing intracranial pressure, cerebrospinal fluid (CSF) LP shunt is widely used for the surgical management; it also carries complications such as shunt migration, venous sinus thrombosis, subarachnoid hemorrhage, and subdural and intracerebral hematoma. A 52-year-old man was admitted to the neurosurgery clinic with severe headache, retro-orbital pain, and blurred vision. Lumbar puncture demonstrated that the CSF opening pressure was 32 cm H O. A nonprogrammable LP shunt with two distal slit valves was inserted. Shortly after the surgery, his condition deteriorated and he became comatose. Immediate computed tomography scan revealed cerebellar hemorrhage and acute hydrocephalus. Development of remote cerebellar hemorrhage following LP shunt is rare. We discuss this rare event and the applicable literature.
特发性颅内高压的特征是颅内压升高,而无脑积水或颅内占位。手术治疗包括视神经开窗术以及脑室腹腔分流术和腰大池腹腔(LP)分流术。为降低颅内压,脑脊液(CSF)腰大池腹腔分流术被广泛用于手术治疗;它也会引发诸如分流管移位、静脉窦血栓形成、蛛网膜下腔出血以及硬膜下和脑内血肿等并发症。一名52岁男性因严重头痛、眶后疼痛和视力模糊入住神经外科门诊。腰椎穿刺显示脑脊液初压为32 cm H₂O。插入了带有两个远端裂隙瓣膜的不可调节腰大池腹腔分流管。术后不久,他的病情恶化并陷入昏迷。立即进行的计算机断层扫描显示小脑出血和急性脑积水。腰大池腹腔分流术后发生远处小脑出血很罕见。我们讨论这一罕见事件及相关适用文献。