Department of neurosurgery, Lariboisière hospital, 2, rue Ambroise Paré, 75010 Paris Cedex 10, France; INSERM U1153, Statistic and Epidemiologic Research Centre Sorbonne Paris Cité (CRESS), ECSTRRA team, Saint-Louis hospital, 1, avenue Claude Vellefaux, 75010 Paris, France.
Department of neurosurgery, Lariboisière hospital, 2, rue Ambroise Paré, 75010 Paris Cedex 10, France.
Neurochirurgie. 2022 Dec;68(6):674-678. doi: 10.1016/j.neuchi.2022.05.007. Epub 2022 Jun 10.
A 36 year old woman was referred to our department for symptomatic lumbar spinal arachnoiditis following an epidural anaesthesia for childbirth. She did not had other known causative factor and she was free of any neurological symptoms before. She rapidly developed lower limbs impairment by compressing intradural lumbar collections and arachnoiditis requiring surgical decompression and subsequently internal cerebrospinal fluid shunting for acute hydrocephalus. Three years and the half later, she developed a severe tetraparesis due to a massive syrinx consecutive to the fourth ventricle outlets obstruction cause by the ongoing diffuse craniocervical junction arachnoiditis. Our aim was to treat all the problems in one step. An open fourth ventriculostomy of the Magendie's foramen with catheter insertion from the fourth ventricle down to the upper cervical subarachnoid space improve both the patient status and imagery.
一位 36 岁女性因分娩行硬膜外麻醉后出现症状性腰椎蛛网膜炎，转至我科治疗。她没有其他已知的病因，且之前没有任何神经症状。她因硬膜内腰椎积液和蛛网膜炎迅速导致下肢功能障碍，需要手术减压，随后因急性脑积水行内置脑脊液分流术。3 年半后，由于颅颈交界区弥漫性蛛网膜粘连持续导致第四脑室出口梗阻，出现巨大脊髓空洞症，她发展为严重的四肢瘫痪。我们的目标是一步解决所有问题。行 Magendie 孔第四脑室开放术并将导管插入第四脑室至上颈椎蛛网膜下腔，改善了患者的状况和影像学表现。
