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儿童后颅窝肿瘤切除术后张力性硬脑膜下血肿：一种新的临床放射病理实体。

Tension Subdural Hygroma Following Resection of Posterior Fossa Tumour in a Child: A new clinico-radio-pathological entity.

机构信息

Department of Neurosurgery, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Sultan Qaboos Univ Med J. 2024 May;24(2):288-292. doi: 10.18295/squmj.9.2023.056. Epub 2024 May 27.

DOI:10.18295/squmj.9.2023.056
PMID:38828259
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11139376/
Abstract

Persistent hydrocephalus is common in children after resection of posterior fossa tumours. However, occurrence of subdural hygroma is very rare. We report the case of a 14-month-old child who presented at a paediatric neurology clinic in Muscat, Oman in 2021 who developed a tense subdural hygroma with stable hydrocephalus, in the early postoperative period, following posterior fossa tumour resection. We describe the distinctive clinical, radiological and pathological features associated with the development of a tense subdural hygroma. We also discuss the management by cerebrospinal fluid diversion, which includes either a ventriculoperitoneal or subduroperitoneal shunt. This unique condition is distinguished from external hydrocephalus by features that are critical to the management strategy.

摘要

术后后脑积水在儿童中很常见，但硬脑膜下积血则很少见。我们报告了 2021 年在阿曼马斯喀特的一家儿科神经科诊所就诊的 14 个月大的儿童病例，该患儿在小脑后肿瘤切除术后的早期出现了张力性硬脑膜下积血伴稳定的脑积水。我们描述了与张力性硬脑膜下积血发展相关的独特的临床、放射学和病理学特征。我们还讨论了通过脑脊液引流的治疗方法，包括脑室-腹腔分流或硬膜下-腹腔分流。这种独特的情况与外部性脑积水的区别在于对治疗策略至关重要的特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/d68848199a49/squmj2405-288-292f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/54ca85b24a53/squmj2405-288-292f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/1290331a0981/squmj2405-288-292f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/d68848199a49/squmj2405-288-292f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/54ca85b24a53/squmj2405-288-292f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/1290331a0981/squmj2405-288-292f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b16c/11139376/d68848199a49/squmj2405-288-292f3.jpg

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本文引用的文献

1
Hydrocephalus Associated with Posterior Fossa Tumors: How to Manage Effectively?后颅窝肿瘤相关脑积水：如何有效管理？
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Management of hydrocephalus in children with posterior fossa tumors.后颅窝肿瘤患儿脑积水的管理
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Factors predicting the need for cerebrospinal fluid diversion following posterior fossa tumor surgery in children.
预测儿童后颅窝肿瘤手术后脑脊液分流需求的因素。
Pediatr Neurosurg. 2012;48(2):93-101. doi: 10.1159/000343009. Epub 2012 Oct 4.
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Postoperative extra-axial cerebrospinal fluid collection--its pathophysiology and clinical management.术后轴外脑脊液积聚——其病理生理学与临床处理
Pediatr Neurosurg. 2011;47(2):125-32. doi: 10.1159/000330543. Epub 2011 Sep 2.
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Predicting postresection hydrocephalus in pediatric patients with posterior fossa tumors.预测小儿后颅窝肿瘤患者术后脑积水情况。
J Neurosurg Pediatr. 2009 May;3(5):378-85. doi: 10.3171/2009.1.PEDS08298.
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Hydrocephalus in posterior fossa tumors in children. Are there factors that determine a need for permanent cerebrospinal fluid diversion?儿童后颅窝肿瘤中的脑积水。是否存在决定永久性脑脊液分流需求的因素？
Childs Nerv Syst. 2008 Dec;24(12):1397-403. doi: 10.1007/s00381-008-0649-x. Epub 2008 May 31.
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Posterior fossa surgery complicated by a pseudomeningocele, bilateral subdural hygromata and cerebellar cognitive affective syndrome.后颅窝手术并发假性脑脊膜膨出、双侧硬膜下积液和小脑认知情感综合征。
Br J Neurosurg. 2008 Feb;22(1):107-9. doi: 10.1080/02688690701551668.
8
Management of hydrocephalus in children with posterior fossa tumors: role of tumor surgery.后颅窝肿瘤患儿脑积水的管理：肿瘤手术的作用
Pediatr Neurosurg. 2007;43(2):92-6. doi: 10.1159/000098379.
9
Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified?儿童后颅窝肿瘤早期手术治疗后持续性脑积水：术前常规内镜下第三脑室造瘘术是否合理？
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10
Analysis of CSF shunting procedure requirement in children with posterior fossa tumors.后颅窝肿瘤患儿脑脊液分流手术需求分析
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