Chen Tzu-Ning, Kuo Keng-Liang, Lin Chih-Lung, Su Yu-Feng
Department of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan.
Korean J Neurotrauma. 2023 Nov 14;19(4):466-470. doi: 10.13004/kjnt.2023.19.e57. eCollection 2023 Dec.
Post-traumatic hydrocephalus (PTH) is a commonly encountered complication following decompressive craniectomy, and is usually characterized by symptoms including headache, nausea, vomiting, and papilledema. Extracranial herniation accompanied by hemiplegia is a rare complication in patients with PTH who underwent craniectomy after subdural hematoma removal. We report a case of PTH that presented with extracranial herniation within one month of decompressive craniectomy. Following ventriculoperitoneal shunt implantation, left hemiplegia improved dramatically with restoration of the left middle cerebral artery blood flow, which was evident on serial imaging. Vascular compromise is often overshadowed by increased intracranial pressure when clinicians are dealing with traumatic brain injury patients. Delicate neurological and radiological examinations and prompt early interventions could lead to optimal outcomes in patients receiving decompressive craniectomy.
创伤后脑积水（PTH）是减压性颅骨切除术后常见的并发症，通常表现为头痛、恶心、呕吐和视乳头水肿等症状。伴有偏瘫的颅外疝是PTH患者在硬膜下血肿清除术后行颅骨切除术后罕见的并发症。我们报告1例PTH患者，在减压性颅骨切除术后1个月内出现颅外疝。在脑室腹腔分流置入术后，随着大脑中动脉左侧血流的恢复，左侧偏瘫明显改善，这在系列影像学检查中很明显。当临床医生处理创伤性脑损伤患者时，血管受压常被颅内压升高所掩盖。细致的神经和影像学检查以及及时的早期干预可使接受减压性颅骨切除术的患者获得最佳预后。
