Husag L, Costabile G, Probst C
Neurochirurgia (Stuttg). 1984 May;27(3):82-5. doi: 10.1055/s-2008-1053735.
We report a case of choroid plexus papilloma of the left lateral ventricle, which illustrates the difficulties of diagnosis of these tumours with air studies in advanced hydrocephalus. The hydrocephalus was apparent at the age of three months, but ventriculography failed to reveal the true nature of the communicating hydrocephalus. A ventriculocaval shunt was inserted, but the hydrocephalus progressed, in spite of the fact that the shunt was functioning well. The diagnosis of a papilloma of the choroid plexus was made after performing a CT examination at the age of 3 1/2 years. In spite of radical tumour removal, three years after the operation the axial computer tomography revealed a persistent hydrocephalus, but no recurrence of tumour. To control the hydrocephalus, a bilateral shunt with low pressure valve was necessary. With reference to the literature we discuss the possible causes of persistent hydrocephalus after surgical removal of these tumours. The majority of authors concluded, that because of repeated subarachnoid bleeding by these tumours, it must be a form of aresorptive hydrocephalus. The persisting hydrocephalus is probably caused by an increase of the CSF outflow resistance because of a distal CSF-pathway obstruction.
我们报告一例左侧脑室脉络丛乳头状瘤病例，该病例说明了在晚期脑积水情况下通过空气造影研究诊断这些肿瘤的困难。脑积水在三个月大时就很明显，但脑室造影未能揭示交通性脑积水的真实性质。插入了脑室-腔静脉分流管，但尽管分流管功能良好，脑积水仍在进展。在3岁半时进行CT检查后确诊为脉络丛乳头状瘤。尽管肿瘤被彻底切除，但术后三年的轴向计算机断层扫描显示脑积水持续存在，但无肿瘤复发。为控制脑积水，需要植入双侧低压阀分流管。参照文献，我们讨论了手术切除这些肿瘤后持续性脑积水的可能原因。大多数作者得出结论，由于这些肿瘤反复引起蛛网膜下腔出血，这一定是一种吸收性脑积水的形式。持续性脑积水可能是由于远端脑脊液通路阻塞导致脑脊液流出阻力增加所致。
