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不常见病因所致梗阻性脑积水：青少年时期表现为导水管狭窄的病例报告和神经外科治疗。

Obstructive hydrocephalus of uncommon etiology: case report and neurosurgical management of aqueductal web presenting in adolescence.

机构信息

Neurosurgery Department, Cedars Sinai Medical Center, Los Angeles, CA, USA.

Radiology Department, Cedars Sinai Medical Center, Los Angeles, CA, USA.

出版信息

Childs Nerv Syst. 2024 Dec;40(12):4389-4392. doi: 10.1007/s00381-024-06645-9. Epub 2024 Nov 1.

DOI:10.1007/s00381-024-06645-9
PMID:39482561
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11579050/
Abstract

INTRODUCTION

Aqueductal webs are a rare cause of obstructive hydrocephalus. Accurate diagnosis and intervention can prevent neurological complications.

CASE PRESENTATION

Herein, we describe a case of a child presenting with headaches and vomiting. Magnetic resonance imaging (MRI) revealed obstructive tri-ventricular hydrocephalus caused by an aqueductal web. Endoscopic third ventriculostomy (ETV) was successfully performed to restore cerebrospinal fluid (CSF) flow.

CONCLUSION

This case underscores the importance of phase-contrast and T2-weighted cinematic magnetic resonance imaging of cerebrospinal fluid flow for diagnosis of aqueductal webs. These modalities provide valuable insights into CSF dynamics and guidance of appropriate neurosurgical intervention.

摘要

简介

导水管狭窄是引起梗阻性脑积水的罕见原因。准确的诊断和干预可以预防神经并发症。

病例介绍

在此，我们描述了一例以头痛和呕吐为表现的患儿。磁共振成像（MRI）显示由导水管狭窄引起的三脑室梗阻性脑积水。成功实施了内镜第三脑室造瘘术（ETV）以恢复脑脊液（CSF）流动。

结论

本病例强调了相位对比和 T2 加权电影磁共振成像在诊断导水管狭窄中的重要性。这些方法为 CSF 动力学提供了有价值的见解，并指导了适当的神经外科干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/8e0cd9533458/381_2024_6645_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/25c4d1b399e1/381_2024_6645_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/d65c46158997/381_2024_6645_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/6f91e0c5262e/381_2024_6645_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/8e0cd9533458/381_2024_6645_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/25c4d1b399e1/381_2024_6645_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/d65c46158997/381_2024_6645_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/6f91e0c5262e/381_2024_6645_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/11579050/8e0cd9533458/381_2024_6645_Fig4_HTML.jpg

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本文引用的文献

1
Advanced cerebrospinal fluid flow MRI findings of aqueductal stenosis caused by web.由膈膜引起的导水管狭窄的脑脊液流动磁共振成像高级表现
J Clin Ultrasound. 2024 Feb;52(2):201-207. doi: 10.1002/jcu.23606. Epub 2023 Nov 28.
2
A case of aqueductal obstruction by web with no sign except a headache.一例因蛛网膜造成导水管梗阻的病例，除头痛外无其他症状。
Radiol Case Rep. 2022 Aug 5;17(10):3767-3769. doi: 10.1016/j.radcr.2022.07.036. eCollection 2022 Oct.
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Endoscopic Third Ventriculostomy versus Ventriculoperitoneal Shunt in Patients with Obstructive Hydrocephalus: Meta-Analysis of Randomized Controlled Trials.
内镜第三脑室造瘘术与脑室-腹腔分流术治疗梗阻性脑积水的疗效比较：随机对照试验的荟萃分析。
World Neurosurg. 2019 Sep;129:334-340. doi: 10.1016/j.wneu.2019.04.255. Epub 2019 May 25.
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Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus.内镜下第三脑室造瘘术治疗儿童脑积水
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Endoscopic aqueductoplasty in the treatment of aqueductal stenosis.内镜下导水管成形术治疗导水管狭窄
Childs Nerv Syst. 2007 Nov;23(11):1263-8. doi: 10.1007/s00381-007-0393-7. Epub 2007 Aug 4.
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Indications for neuroendoscopic aqueductoplasty without stenting for obstructive hydrocephalus due to aqueductal stenosis.因导水管狭窄导致梗阻性脑积水而不置入支架的神经内镜下导水管成形术的适应证。
Minim Invasive Neurosurg. 2005 Jun;48(3):136-41. doi: 10.1055/s-2004-830265.
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Aqueduct stenosis. Case review and discussion.导水管狭窄。病例回顾与讨论。
J Neurol Neurosurg Psychiatry. 1977 Jun;40(6):521-32. doi: 10.1136/jnnp.40.6.521.