Verma Deepti, Low David Chyi Yeu, Lim Joel Kian Boon
Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
Neurosurgical Service, Division of Surgery, KK Women's and Children's Hospital, Singapore, Singapore.
J Pediatr Intensive Care. 2020 Jul 29;10(4):311-316. doi: 10.1055/s-0040-1713677. eCollection 2021 Nov.
Ventriculoperitoneal shunt (VPS) obstruction may have a myriad of presentations. We reported a case of an 11-year-old girl presenting with acute, bilateral proptosis secondary to VPS obstruction. While neuroimaging was interpreted as unremarkable, fundoscopy revealed bilateral papilledema and lumbar puncture showed elevated intracranial pressure. Neurosurgical exploration demonstrated VPS valve obstruction and a new VPS was inserted. Postoperatively, she developed a recurrent extradural hematoma, which was initially evacuated and later managed conservatively. To our knowledge, this is the first report of bilateral proptosis secondary to VPS obstruction. This case highlights the value of key clinical findings and limitations of neuroimaging.
脑室腹腔分流术（VPS）梗阻可能有多种表现形式。我们报告了一例11岁女孩，因VPS梗阻出现急性双侧眼球突出。虽然神经影像学检查结果显示无异常，但眼底镜检查发现双侧视乳头水肿，腰椎穿刺显示颅内压升高。神经外科探查发现VPS瓣膜梗阻，并植入了新的VPS。术后，她出现了复发性硬膜外血肿，最初进行了血肿清除，后来采取保守治疗。据我们所知，这是首例关于VPS梗阻继发双侧眼球突出的报告。该病例突出了关键临床发现的价值以及神经影像学检查的局限性。
