Bin Saqyan Turki M, Basunbul Lama I, Badahdah Ahmed A, Saleh Yasir A, Filimban Suhail S, Alwabari Ali A, Almutairi Ahmad A, Alanazi Sultanah R, Alghamdi Abdulrazaq S, Aldadi Bader O, Alghamdi Bakheet A, Alzahrani Shafi A, Alzahrani Ahmed R, Alghamdi Osama H, Alshammari Malak
College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, SAU.
College of Medicine, King Abdulaziz University, Jeddah, SAU.
Cureus. 2021 Oct 21;13(10):e18956. doi: 10.7759/cureus.18956. eCollection 2021 Oct.
We present the case of a 69-year-old man patient who was brought with a history of gait disturbances, memory impairment, and urinary incontinence with gradual worsening over the past six months. The patient underwent magnetic resonance imaging of the brain which demonstrated enlarged ventricles, widening of the Sylvian fissure, and narrow sulci at the vertex. Subsequently, the patient underwent a lumbar puncture which revealed a normal opening pressure with normal cerebrospinal fluid analysis. The diagnosis of normal pressure hydrocephalus was established. The patient underwent a ventriculoperitoneal shunt for the management of his symptoms. Three years after the placement of the shunt, the patient was brought to the emergency department with an expanding right-sided subcutaneous abdominal mass. A computed tomography scan of the abdomen showed the subcutaneous mass superficial to the right rectus muscle and was containing the coiled distal end of the shunt. Such findings were consistent with a subcutaneous cerebrospinal fluid pseudocyst. The mass was aspirated and the fluid analysis was in keeping with the cerebrospinal fluid characteristics. The fluid culture revealed no bacterial growth. The ventriculoperitoneal shunt was replaced with a minimally invasive technique.
我们报告一例69岁男性患者，其因步态障碍、记忆障碍和尿失禁病史前来就诊，症状在过去六个月逐渐加重。患者接受了脑部磁共振成像检查，结果显示脑室扩大、大脑外侧裂增宽以及头顶脑沟变窄。随后，患者接受了腰椎穿刺，结果显示初压正常，脑脊液分析正常。确诊为正常压力脑积水。患者接受了脑室腹腔分流术以缓解症状。分流管置入三年后，患者因右侧腹部皮下肿块增大被送往急诊科。腹部计算机断层扫描显示皮下肿块位于右腹直肌浅表，内含分流管的盘绕远端。这些发现符合皮下脑脊液假性囊肿。抽吸肿块，液体分析结果与脑脊液特征相符。液体培养未发现细菌生长。采用微创技术更换了脑室腹腔分流管。
