Liţescu Mircea, Cristian Daniel Alin, Coman Violeta Elena, Erchid Anwar, Pleşea Iancu Emil, Bordianu Anca, Lupaşcu-Ursulescu Corina Veronica, Florea Costin George, Coman Ionuţ Simion, Grigorean Valentin Titus
Discipline of Surgery and General Anesthesia-"Sf. Ioan" Clinical Emergency Hospital, 2nd Department, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
General Surgery Department, "Sf. Ioan" Clinical Emergency Hospital, 13 Vitan-Bârzeşti Road, 042122 Bucharest, Romania.
J Clin Med. 2023 Jul 26;12(15):4919. doi: 10.3390/jcm12154919.
The objectives of this article are to present an original surgical procedure for the temporary or definitive resolution of hydrocephalus, in the case of repeated failure of standard treatment techniques, and to present a case that was resolved using this surgical technique.
We present the case of a 20-year-old male patient with congenital hydrocephalus who underwent a number of 39 shunt revisions, given the repetitive dysfunctions of various techniques (ventriculo-peritoneal shunt, ventriculo-cardiac shunt). The patient was evaluated with the ventricular catheter externalized at the distal end and it was necessary to find an emergency surgical solution, considering the imminent risk of meningitis. The patient was also associated with the diagnosis of acute lithiasic cholecystitis.
The final chosen solution, right ventriculo-venous drainage using the cephalic vein, was a temporary surgical solution, but there are signs that this procedure can provide long-term ventricular drainage.
Transcephalic ventriculo-subclavian drainage represents an alternative technical option, which can be used when established options become ineffective.
本文的目的是介绍一种在标准治疗技术反复失败的情况下,用于暂时或最终解决脑积水问题的原创手术方法,并介绍一例使用该手术技术解决问题的病例。
我们介绍了一名20岁先天性脑积水男性患者的病例,鉴于各种技术(脑室-腹腔分流术、脑室-心脏分流术)反复出现功能障碍,该患者接受了39次分流术修复。患者通过远端外置脑室导管进行评估,考虑到即将发生脑膜炎的风险,有必要找到一种紧急手术解决方案。该患者还被诊断为急性结石性胆囊炎。
最终选择的解决方案是使用头静脉进行右脑室-静脉引流,这是一种临时手术解决方案,但有迹象表明该手术可提供长期脑室引流。
经头脑室-锁骨下引流是一种替代技术选择,当既定选择无效时可使用。