Champagne Pierre-Olivier, Cayouette Florence, Lortie Anne, Decarie Jean-Claude, Weil Alexander G
Departments of1Pediatric Neurosurgery.
2Neurology, and.
J Neurosurg Pediatr. 2018 Dec 1;22(6):659-662. doi: 10.3171/2018.7.PEDS18237. Epub 2018 Sep 21.
The occipital and marginal sinuses, when present, must be sacrificed in order to open the dura in most posterior fossa surgeries in the pediatric population, including posterior fossa decompression for Type I Chiari malformation (CM-I) with duraplasty. Apart from the immediate risk of hemorrhage, the voluntary occlusion of this structure is almost universally well tolerated. The authors report a case of intracranial hypertension following the sacrifice of occipital and marginal sinuses following posterior fossa decompression with duraplasty for CM-I. The specific draining pattern variant of the occipital and marginal sinuses leading to this complication as well as avoidance and management strategies of this condition are discussed.
枕窦和边缘窦（若存在）在大多数小儿后颅窝手术中，为打开硬脑膜都必须予以牺牲，包括对Ⅰ型 Chiari 畸形（CM -Ⅰ）行后颅窝减压并进行硬脑膜成形术时。除了有立即出血的风险外，主动闭塞该结构几乎普遍耐受性良好。作者报告了 1 例在对 CM -Ⅰ行后颅窝减压并进行硬脑膜成形术后，因牺牲枕窦和边缘窦而出现颅内高压的病例。文中讨论了导致该并发症的枕窦和边缘窦的特定引流模式变异以及对此情况的避免和处理策略。
