颅骨碎骨减压术治疗儿童难治性特发性颅内高压

Cranial morcellation decompression for refractory idiopathic intracranial hypertension in children.

作者信息

Ballestero Matheus Fernando Manzolli, Teixeira Thiago Lyrio, Augusto Lucas Pires, de Souza Stephanie Naomi Funo, Santos Marcelo Volpon, de Oliveira Ricardo Santos

机构信息

Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil.

出版信息

Childs Nerv Syst. 2018 Jun;34(6):1111-1117. doi: 10.1007/s00381-018-3766-1. Epub 2018 Mar 3.

DOI:10.1007/s00381-018-3766-1

PMID:29502207

Abstract

BACKGROUND

Primary idiopathic intracranial hypertension (PIIH) in children is rare and has a poorly understood pathophysiology. It is characterized by raised intracranial pressure (ICP) in the absence of an identified brain lesion. Diagnosis is usually confirmed by the measurement of a high cerebrospinal fluid (CSF) opening pressure and exclusion of secondary causes of intracranial hypertension. Refractory PIIH may lead to severe visual impairment. The purpose of this study was to evaluate a cranial morcellation decompression (CMD) technique as a new surgical alternative to stabilize intracranial pressure in PIIH.

MATERIALS AND METHODS

A literature review was carried out, disclosing only 7 pediatric cases of PIIH treated with surgical skull expansion. In addition, we describe here one case of our own experience treated by CMD.

CONCLUSIONS

CMD surgery is a safe and effective option to control refractory PIIH in selected patients.

摘要

背景

儿童原发性特发性颅内高压（PIIH）较为罕见，其病理生理学机制尚不清楚。其特征是在未发现脑部病变的情况下颅内压（ICP）升高。诊断通常通过测量高脑脊液（CSF）初压并排除颅内高压的继发性原因来确诊。难治性PIIH可能导致严重视力损害。本研究的目的是评估颅骨粉碎减压术（CMD）作为一种新的手术方法，用于稳定PIIH患者的颅内压。