Newman N J
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
Surv Ophthalmol. 1994 Jan-Feb;38(4):365-70. doi: 10.1016/0039-6257(94)90074-4.
A 15-year-old girl with a ventriculoperitoneal shunt for congenital hydrocephalus presented with bilateral visual loss and disc edema. Although a CT scan showed no change in ventricular size, subsequent evaluation revealed elevated intracranial pressure and shunt malfunction. Initial visual loss was secondary to chronic papilledema. The rapid reduction of longstanding elevated intracranial pressure may have contributed to worsening of visual function after shunt revision. Subsequent optic nerve sheath fenestration did not improve visual function. In patients with treated hydrocephalus and symptoms of signs of raised intracranial pressure, shunt malfunction should be suspected even if neuro-imaging proves unremarkable.
一名因先天性脑积水接受脑室腹腔分流术的15岁女孩出现双侧视力丧失和视盘水肿。尽管CT扫描显示脑室大小无变化，但后续评估发现颅内压升高和分流器故障。最初的视力丧失继发于慢性视乳头水肿。长期升高的颅内压迅速降低可能导致分流器修复后视觉功能恶化。随后的视神经鞘开窗术并未改善视觉功能。对于接受过脑积水治疗且有颅内压升高症状体征的患者，即使神经影像学检查无异常，也应怀疑分流器故障。
