Department of Neurological Surgery, Vanderbilt University Medical Center, Medical Center North T-4224, Nashville, TN, 37212, USA.
Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, TN, USA.
Childs Nerv Syst. 2021 Nov;37(11):3365-3373. doi: 10.1007/s00381-021-05142-7. Epub 2021 Mar 26.
Primary brain tumors diagnosed during infancy present several challenges for the pediatric neurosurgeon including the management of tumor-related hydrocephalus. Infant tumor-related hydrocephalus (iTRH) is present in over 70% of new diagnoses overall and in over 90% of infants with infratentorial neoplasms. iTRH may be related to direct obstruction of cerebrospinal fluid (CSF) pathways, shedding of protein and/or cells leading to dysfunctional subarachnoid, tumor-related CSF production, or, most frequently, a combination of these mechanisms. Treatment plans must consider the acuity of presentation, the mechanism of iTRH, and the additional neoadjuvant or adjuvant therapies required to treat the neoplasm. This narrative review provides a broad reference on the epidemiology, pathophysiology, and treatment of iTRH.
婴儿期诊断的原发性脑肿瘤给小儿神经外科医生带来了诸多挑战，其中包括肿瘤相关脑积水的处理。婴儿肿瘤相关脑积水（iTRH）在总体新诊断病例中占 70%以上，在幕下肿瘤患儿中占 90%以上。iTRH 可能与脑脊液（CSF）通路的直接阻塞、蛋白质和/或细胞脱落导致功能障碍性蛛网膜下腔、肿瘤相关 CSF 产生有关，或最常见的是这些机制的组合。治疗计划必须考虑到发病的紧迫性、iTRH 的机制，以及为治疗肿瘤所需的新辅助或辅助治疗。本综述性文章广泛介绍了 iTRH 的流行病学、病理生理学和治疗方法。
