Yang Chenlong, Deng Xiaofeng, Yang Jun, Xu Yulun
Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Childs Nerv Syst. 2019 Apr;35(4):707-711. doi: 10.1007/s00381-018-4014-4. Epub 2019 Jan 4.
Shunt dependency syndrome is a rare long-term complication of cystoperitoneal (CP) shunting for intracranial arachnoid cysts, which is characterized by acute intracranial hypertension with normal-sized or small ventricles. Additionally, acquired Chiari type I malformations (ACIM) could be infrequently secondary to extrathecal shunt drainage of cerebrospinal fluid.
We described a 12-year-old boy who developed shunt dependency syndrome following a CP shunting for treating a temporal arachnoid cyst. To manage this rare complication, we placed a lumboperitoneal (LP) shunt. During the follow-up period, shunt-induced ACIM and concomitant syringomyelia were noted.
Shunt dependency syndrome is a rare complication secondary to CP shunting in the treatment of temporal arachnoid cysts, and LP shunting is an effective option to relieve the intracranial hypertension. However, the clinicians should be alert to the ACIM as a rare late complication of cerebrospinal fluid diversion procedures, and the potential protecting effect of the programmable valve should be emphasized.
分流依赖综合征是颅内蛛网膜囊肿行囊肿 - 腹腔（CP）分流术罕见的长期并发症，其特征为脑室大小正常或较小情况下出现急性颅内高压。此外，后天性 Chiari I 型畸形（ACIM）可能偶尔继发于脑脊液鞘外分流引流。
我们描述了一名 12 岁男孩，其在接受 CP 分流术治疗颞叶蛛网膜囊肿后发生了分流依赖综合征。为处理这一罕见并发症，我们置入了腰 - 腹腔（LP）分流管。在随访期间，发现了分流诱导的 ACIM 和并发的脊髓空洞症。
分流依赖综合征是颞叶蛛网膜囊肿治疗中 CP 分流术继发的罕见并发症，LP 分流术是缓解颅内高压的有效选择。然而，临床医生应警惕 ACIM 作为脑脊液分流术罕见的晚期并发症，并应强调可编程阀门的潜在保护作用。
