骨过度生长导致近端脑室腹腔分流术故障。
Bone Overgrowth Causing Proximal Ventriculoperitoneal Shunt Malfunction.
作者信息
Kim Michael, Rybkin Ilya, Smith Harrison, Cooper Jared, Tobias Michael
机构信息
Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA.
New York Medical College, Valhalla, New York, USA.
出版信息
World Neurosurg. 2019 Jan;121:127-130. doi: 10.1016/j.wneu.2018.10.030. Epub 2018 Oct 12.
BACKGROUND
Hydrocephalus is an international disease process that is commonly treated surgically with a ventriculoperitoneal shunt. This device may be prone to malfunction, most commonly from obstruction, disconnection, or infection.
CASE DESCRIPTION
A 35-year-old female with hydrocephalus and a ventriculoperitoneal shunt presented with altered mental status and imaging concerning for a shunt malfunction. Intraoperatively, she was found to have bone growing over and compressing the proximal occluder of the shunt valve, causing a mechanical obstruction. Removal of the bone allowed for egress of cerebrospinal fluid and return of proper shunt function. The patient did well postoperatively.
CONCLUSION
Hydrocephalus, ventriculoperitoneal shunts, and shunt revisions represent a significant health burden and cost. Here we present an unusual cause of a shunt malfunction caused by bony overgrowth.
背景
脑积水是一种国际性疾病，通常通过脑室腹腔分流术进行手术治疗。该装置可能容易出现故障，最常见的原因是阻塞、断开连接或感染。
病例描述
一名35岁患有脑积水且接受了脑室腹腔分流术的女性出现精神状态改变，影像学检查提示分流器故障。术中发现她的骨头生长并压迫分流阀的近端封堵器，导致机械性阻塞。去除骨头后，脑脊液得以流出，分流器功能恢复正常。患者术后恢复良好。
结论
脑积水、脑室腹腔分流术和分流器翻修带来了巨大的健康负担和成本。在此，我们报告一例由骨质过度生长导致的分流器故障的罕见原因。
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