Jimenez D F, Keating R, Goodrich J T
Department of Neurosurgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467.
Childs Nerv Syst. 1994 Jan;10(1):59-63. doi: 10.1007/BF00313586.
Reported are the cases of three hydrocephalic patients who developed a clinically heterogenous entity with an allergic rejection of their silicone ventriculoperitoneal shunts. All of the patients had an original presentation indicative of a shunt infection, but laboratory analysis revealed sterile cerebrospinal fluid in all three cases. The typical course included recurrent skin breakdowns over the shunt tract, subsequent infections and development of fungating granulomas. Treatment, with successful resolution of the symptoms, included changing the shunt material from silicone to polyurethane, with immunosuppression in one patient and removal of the shunt altogether in the other two patients. The roles of the immune system and silicone in the pathophysiology of this condition are discussed.
报告了三例脑积水患者的病例，这些患者出现了一种临床异质性疾病，其硅酮脑室腹腔分流管发生了过敏排斥反应。所有患者最初的表现都提示分流管感染，但实验室分析显示所有三例患者的脑脊液均无菌。典型病程包括分流管通道反复出现皮肤破溃、随后发生感染以及形成蕈样肉芽肿。治疗方法包括将分流管材料从硅酮改为聚氨酯，其中一名患者进行免疫抑制，另外两名患者完全移除分流管，症状均成功缓解。本文讨论了免疫系统和硅酮在这种疾病病理生理学中的作用。
