Raut Rupesh, Paudel Shailes, Bhandari Prakriti, Gupta Umang, Nepali Anil
Department of Neurosurgery, Patan Academy of Health Science, Lagankhel, Lalitpur, Nepal.
Department of Intensive Care Unit, Patan Academy of Health Sciences, Lagankhel, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2023 Jul;61(263):617-619. doi: 10.31729/jnma.8219. Epub 2023 Jul 30.
Obstructive infantile hydrocephalus may arise due to anatomic or functional obstruction of cerebrospinal fluid flow. Obstruction of the aqueduct of sylvius (aqueductal stenosis) causes dilation of the lateral and third ventricles, while the size of the fourth ventricle remains relatively normal. Obstructive infantile hydrocephalus with meningoventriculitis is a rare phenomenon, and literature with only 2 other children with similar findings have been reported. We hereby report a case of a 16-week-old infant who developed meningoventriculitis, later complicated by the development of hydrocephalus, challenging the management. The diagnosis was based on the magnetic resonance imaging of the brain, which showed hydrocephalus, and the cerebrospinal fluid culture showing meningoventriculitis. The case was managed with serial ventricular drainage along with antibiotics followed by staged ventriculoperitoneal shunting. Serial measurement of head circumference is essential to prompt diagnostic suspicion in the case of paediatric meningitis.
梗阻性婴儿脑积水可能由于脑脊液流动的解剖学或功能性梗阻而发生。中脑导水管梗阻（导水管狭窄）导致侧脑室和第三脑室扩张，而第四脑室大小相对正常。伴有脑膜脑室炎的梗阻性婴儿脑积水是一种罕见现象，仅有另外2例有类似发现的儿童的文献报道。我们在此报告1例16周龄婴儿，其发生了脑膜脑室炎，随后并发脑积水，给治疗带来挑战。诊断基于脑部磁共振成像显示脑积水，以及脑脊液培养显示脑膜脑室炎。该病例采用连续脑室引流联合抗生素治疗，随后分期进行脑室腹腔分流术。对于小儿脑膜炎病例，连续测量头围对于及时产生诊断怀疑至关重要。
