Friedman P, Gass H H
Neurosurgery. 1981 Sep;9(3):300-2.
A 26-year-old woman had had a lumbar subarachnoid-ureteral shunt established at the age of 10 weeks for hydrocephalus. She developed normally and had no trouble until meningitis developed because of reflux from a urinary tract infection. The meningitis responded to antibiotic treatment, and the shunt was removed from the subarachnoid space. Subsequently, the patient deteriorated clinically, with ictal episodes of altered consciousness, headache, and signs of midbrain dysfunction. Despite normal size ventricles on serial computed tomographic scans, her intracranial pressure was markedly elevated, which was shown by spinal puncture pressure. A diversionary lumboperitoneal shunt was inserted. An immediate, sustained recovery followed. The recognition of increased intracranial pressure in the absence of ventriculomegaly led to management that averted a disastrous outcome.
一名26岁女性在10周大时因脑积水接受了腰蛛网膜下腔-输尿管分流术。她发育正常，直到因尿路感染反流引发脑膜炎之前都没有问题。脑膜炎对抗生素治疗有反应，分流管从蛛网膜下腔移除。随后，患者临床症状恶化，出现意识改变、头痛的发作性症状以及中脑功能障碍的体征。尽管连续的计算机断层扫描显示脑室大小正常，但通过腰椎穿刺压力显示其颅内压明显升高。于是插入了一根腰大池-腹腔分流管。随后患者立即持续康复。在没有脑室扩大的情况下识别出颅内压升高，从而采取了避免灾难性后果的治疗措施。
