Mauler David J, R Richter Kent, Merrill Sarah, Valencia-Sánchez Cristina, Krishna Chandan, M Mrugala Maciej
Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85259, USA.
Department of Neurology, Mayo Clinic, Phoenix, AZ 85054, USA.
Mol Clin Oncol. 2020 Jul;13(1):76-79. doi: 10.3892/mco.2020.2032. Epub 2020 Apr 22.
The authors report the case of a 39-year-old woman with leukemic meningitis. A right frontal Ommaya reservoir was placed for intrathecal chemotherapy. During and immediately following the first injection of chemotherapy, the patient developed an episode of nausea, emesis, frontal headache and diarrhea. These same symptoms were later elicited during a second and third administration of chemotherapy. Post-placement head computed tomography showed the tip of the catheter projecting approximately 1.5 cm inferior to the floor of the left frontal ventricle. After a revision of the Ommaya catheter due to suboptimal positioning, subsequent intrathecal chemotherapy administration was tolerated without any of the adverse symptoms previously encountered. The case documents an unusual complication arising from catheter migration in the setting of intrathecal chemotherapy and also demonstrates the value in troubleshooting Ommaya reservoir complications rather than prematurely abandoning its use in favor of lumbar puncture.
作者报告了一例39岁患白血病性脑膜炎的女性病例。放置了一个右额部的奥马亚贮液器用于鞘内化疗。在首次化疗注射期间及注射后不久，患者出现了恶心、呕吐、额部头痛和腹泻。在第二次和第三次化疗给药期间，同样的症状再次出现。放置贮液器后的头颅计算机断层扫描显示导管尖端位于左额叶脑室底部下方约1.5厘米处。由于定位不理想对奥马亚导管进行修正后，随后的鞘内化疗给药耐受良好，未出现之前遇到的任何不良症状。该病例记录了鞘内化疗过程中导管移位引起的一种不寻常并发症，也证明了对奥马亚贮液器并发症进行故障排除的价值，而不是过早放弃使用它而选择腰椎穿刺。
