Mizoi K, Kayama T, Takaku A, Suzuki J
No Shinkei Geka. 1981 Jan;9(1):99-105.
Four cases of subdural effusion following radical surgery for the chiasmal region tumors in childhood were presented in this report. Three out of four cases were craniopharyngioma and the remaining one was optic glioma. The pathogenetic mechanisms of this disorder were explained probably and at least partly by a change from internal to external hydrocephalus or craniocerebral disproportion due to cerebral atrophy in two of the four cases and unclear in the remaining two cases. In all four cases meningitis did not supervene postoperatively. The subdural effusion may be divided into two types according to symptomatology, i.e., "serious type" which presents with severe symptoms and "mild-type" which is virtually asymptomatic. The serious type required immediate surgical procedure, such as continuous subdural drainage and subduroperitoneal shunt, while the mild type should be carefully monitored for the course of subdural effusion by CT scan.
本报告介绍了4例儿童视交叉区肿瘤根治性手术后发生硬膜下积液的病例。4例中有3例为颅咽管瘤,其余1例为视神经胶质瘤。这种疾病的发病机制可能至少部分是由于4例中的2例因脑萎缩导致从内部脑积水转变为外部脑积水或颅腔与脑比例失调,其余2例机制不明。所有4例术后均未发生脑膜炎。硬膜下积液根据症状学可分为两种类型,即表现为严重症状的“严重型”和几乎无症状的“轻型”。严重型需要立即进行手术,如持续硬膜下引流和硬膜下腹腔分流术,而轻型则应通过CT扫描仔细监测硬膜下积液的病程。