Vitulli Francesca, Spennato Pietro, Cicala Domenico, Mirone Giuseppe, Scala Maria Rosaria, Cinalli Giuseppe
Department of Neurosciences, Neurosurgery Unit, AORN Santobono-Pausilipon Children's Hospital, Naples, Italy.
Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Naples, Italy.
Surg Neurol Int. 2022 Jul 15;13:306. doi: 10.25259/SNI_434_2022. eCollection 2022.
Patients with brain vascular disease and hydrocephalus may be predisposed to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pression. Patients with brain tumor may develop hydrocephalus as a consequence of obstruction of cerebrospinal fluid pathways and radiation-induced moyamoya syndrome secondary (RIMS) to radiotherapy (RT).
A 15-year-old male patient, affected by hydrocephalus and RIMS, presented acute cerebral ischemia after an episode of shunt malfunction. The shunt was promptly revised and the areas of ischemia visible at magnetic resonance imaging significantly decreased.
Children who receive RT for brain tumor, particularly if the circle of Willis region is involved, require close surveillance for the development of vasculopathy and consequent stroke. This surveillance must be even tighter if the patient has been treated with ventricular shunt for the possible synergistic interaction between the two causes on reducing cerebral perfusion and increasing the risk of acute ischemic events.
脑血管疾病和脑积水患者在分流功能障碍及随后颅内压升高的情况下，可能易患急性缺血性卒中。脑肿瘤患者可能因脑脊液通路阻塞以及放疗后继发的放射性烟雾病综合征（RIMS）而发生脑积水。
一名15岁男性患者，患有脑积水和RIMS，在一次分流故障发作后出现急性脑缺血。分流装置迅速得到修复，磁共振成像可见的缺血区域明显缩小。
接受脑部放疗的儿童，尤其是如果 Willis 环区域受累，需要密切监测血管病变及随后发生的卒中情况。如果患者已接受脑室分流治疗，由于这两种病因在降低脑灌注和增加急性缺血事件风险方面可能存在协同作用，这种监测必须更加严格。
