Kondoh Takeshi, Miura Shinichi, Nakahara Masahiro, Mizowaki Takashi, Tanaka Hirotomo, Takaishi Yoshiyuki
Department of Neurosurgery, Shinsuma General Hospital, 3-1-14 Kinugake-cho, Suma- ku, Kobe, 654-0048 Japan.
Radiol Case Rep. 2022 Feb 3;17(4):1076-1081. doi: 10.1016/j.radcr.2022.01.009. eCollection 2022 Apr.
A 13-year-old boy, with a history of intermittent headache and transient diplopia, was found to have non-hemorrhagic cerebral arteriovenous malformation in the midbrain tegmental region associated with hydrocephalus. Gamma knife radiosurgery was performed at 16 Gy with 75% marginal dose. Posttreatment course was uneventful. Follow-up MR imaging at one year after the treatment revealed complete disappearance of the abnormal vascular flow voids. The size of each ventricle at the treatment and at one year after treatment were as follows; 60.2 cc and 20.9 cc in the lateral ventricles, 3.7 cc and 2.7 cc in the third ventricle. The hydrocephalus might be caused by obstructive mechanism but mostly by high venous pressure due to the shunt blood flow. The goal of treatment for hydrocephalus should be nidus obstruction and normalizing the vascular flow.
一名13岁男孩，有间歇性头痛和短暂性复视病史，被发现中脑被盖区存在非出血性脑动静脉畸形并伴有脑积水。采用伽玛刀放射外科治疗，边缘剂量为75%，剂量为16 Gy。治疗过程顺利。治疗后一年的随访磁共振成像显示异常血管流空完全消失。治疗时及治疗后一年各脑室大小如下：侧脑室分别为60.2 cc和20.9 cc，第三脑室分别为3.7 cc和2.7 cc。脑积水可能由梗阻机制引起，但主要是由于分流血流导致的高静脉压。脑积水的治疗目标应该是阻塞病灶并使血管血流正常化。
