Soon Wai Cheong, Thanabalasundaram Gopiga, Thant Kyaw Zayar, Ogbonnaya Ebere Sunny, Harrisson Stuart Edward
Department of Neurosurgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Department of Neurosurgery, University Hospital North Midlands, Stoke-on-Trent, UK.
J Surg Case Rep. 2018 Apr 6;2018(4):rjy049. doi: 10.1093/jscr/rjy049. eCollection 2018 Apr.
Odontoid pannus or periodontoid pseudotumour is associated with a variety of rheumatological conditions. We report a case of an 80-year old man who presented with acute hydrocephalus following an emergency operation to amputate his infected left big toe. Imaging revealed a large tissue mass causing severe compression at the cervico-medullary junction and obstruction of CSF flow. The acute hydrocephalus was presumed to be related to neck manoeuvring during general anaesthesia. Following an initial emergency CSF diversion through external ventricular drainage catheter insertion, the patient subsequently underwent ventriculo-peritoneal insertion and posterior spinal decompression and fixation. To our knowledge, there have been no reported cases of tophaceous gout of the odontoid pannus causing acute hydrocephalus.
齿突滑膜皱襞或齿突周围假瘤与多种风湿性疾病相关。我们报告一例80岁男性患者，在急诊手术切除其感染的左大脚趾后出现急性脑积水。影像学检查显示一个大的组织肿块，在颈髓交界处造成严重压迫并阻塞脑脊液流动。急性脑积水被推测与全身麻醉期间的颈部操作有关。在最初通过插入外部脑室引流导管进行紧急脑脊液分流后，患者随后接受了脑室-腹腔分流术以及后路脊髓减压和固定术。据我们所知，尚无齿突滑膜皱襞痛风石导致急性脑积水的病例报道。
