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伴Chiari I畸形的视乳头水肿经脑室腹腔分流术后消退

Resolution of Papilledema Associated with Chiari I Malformation with Ventriculoperitoneal Shunting.

作者信息

Jivraj Imran, Liu Grant, Sharma Nikhil, Glauser Gregory, Grady Michael Sean, Malhotra Neil Rainer

机构信息

Department of Neurology and Ophthalmology, Hospital of the University of Pennsylvania, Pennsylvania, USA.

Department of Neurosurgery, Hospital of the University of Pennsylvania, Pennsylvania, USA.

出版信息

Asian J Neurosurg. 2019 Apr-Jun;14(2):598-601. doi: 10.4103/ajns.AJNS_33_19.

DOI:10.4103/ajns.AJNS_33_19
PMID:31143293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6516035/
Abstract

Chiari malformation type 1 (CMI) usually presents with cervical pain and suboccipital headache, among other symptoms. Patients with CMI describe symptoms that are clearly correlated with CMI for an average of 3.1 years before diagnosis. We present a case of a patient with bilateral papilledema and CMI but with no long-standing CMI symptoms. She was initially diagnosed with a concussion but developed unremitting intense occipital headaches 4 days later which prompted an evaluation for an alternative diagnosis. Treatment of this case was ventriculoperitoneal shunting, which may serve as an alternative to posterior fossa decompression under certain circumstances.

摘要

1型 Chiari 畸形（CMI）通常表现为颈部疼痛和枕下头痛等症状。CMI 患者在诊断前平均3.1年描述的症状与 CMI 明显相关。我们报告一例双侧视乳头水肿合并 CMI 但无长期 CMI 症状的患者。她最初被诊断为脑震荡，但4天后出现持续剧烈的枕部头痛，这促使对其进行进一步评估以寻找其他诊断。该病例的治疗方法是脑室腹腔分流术，在某些情况下，这可能是后颅窝减压术的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/a1efcd26e509/AJNS-14-598-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/4dca6e4eac51/AJNS-14-598-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/9f1d0c0d3873/AJNS-14-598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/a1efcd26e509/AJNS-14-598-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/4dca6e4eac51/AJNS-14-598-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/9f1d0c0d3873/AJNS-14-598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fb2/6516035/a1efcd26e509/AJNS-14-598-g003.jpg

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本文引用的文献

1
Commentary: The Dilemma of Papilledema in Chiari I Malformation.评论：Chiari I型畸形中视乳头水肿的困境
Neurosurgery. 2018 Mar 1;82(3):E73-E74. doi: 10.1093/neuros/nyx577.
2
Comparison of Results Between Posterior Fossa Decompression with and without Duraplasty for the Surgical Treatment of Chiari Malformation Type I: A Systematic Review and Meta-Analysis.I型Chiari畸形手术治疗中后颅窝减压术加或不加硬脑膜成形术的结果比较：一项系统评价和荟萃分析
World Neurosurg. 2018 Feb;110:460-474.e5. doi: 10.1016/j.wneu.2017.10.161. Epub 2017 Nov 11.
3
Chiari I malformation with underlying pseudotumor cerebri: Poor symptom relief following posterior decompression surgery.
伴有潜在特发性颅内压增高的Chiari I畸形：后颅窝减压术后症状缓解不佳。
Int J Surg Case Rep. 2017;38:136-141. doi: 10.1016/j.ijscr.2017.07.039. Epub 2017 Jul 22.
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Trends in surgical treatment of Chiari malformation Type I in the United States.美国I型 Chiari 畸形的外科治疗趋势
J Neurosurg Pediatr. 2017 Feb;19(2):208-216. doi: 10.3171/2016.8.PEDS16273. Epub 2016 Nov 11.
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The relationship between obesity and symptomatic Chiari I malformation in the pediatric population.儿童人群中肥胖与症状性Chiari I型畸形之间的关系。
J Pediatr Neurosci. 2015 Oct-Dec;10(4):321-5. doi: 10.4103/1817-1745.174443.
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Complicated Pseudomeningocele Repair After Chiari Decompression: Case Report and Review of the Literature.Chiari减压术后复杂假性脑脊膜膨出修复术：病例报告及文献综述
World Neurosurg. 2016 Apr;88:688.e1-688.e7. doi: 10.1016/j.wneu.2015.11.056. Epub 2015 Dec 17.
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A case of papilloedema associated with Chiari I malformation.一例与Chiari I型畸形相关的视乳头水肿病例。
J Neurol Sci. 2015;353(1-2):183-4. doi: 10.1016/j.jns.2015.04.016. Epub 2015 Apr 17.
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Idiopathic intracranial hypertension (pseudotumor cerebri): recognition, treatment, and ongoing management.特发性颅内高压（假性脑瘤）：识别、治疗和持续管理。
Curr Treat Options Neurol. 2013 Feb;15(1):1-12. doi: 10.1007/s11940-012-0207-4.
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Papilloedema due to Chiari I malformation.由于Chiari I型畸形导致的视乳头水肿。
BMJ Case Rep. 2011 Oct 16;2011:bcr0820114721. doi: 10.1136/bcr.08.2011.4721.
10
Chiari malformation presenting with pseudotumor cerebri: what is the best treatment?
Acta Neurol Belg. 2012 Dec;112(4):389-92. doi: 10.1007/s13760-012-0066-5. Epub 2012 Apr 25.