Eggenberger E R, Miller N R, Vitale S
Neuro-Ophthalmology Unit, Johns Hopkins Hospital, Baltimore, MD, USA.
Neurology. 1996 Jun;46(6):1524-30. doi: 10.1212/wnl.46.6.1524.
We conducted a retrospective study of 27 patients with pseudotumor cerebri (PTC) treated with at least one lumboperitoneal shunt (LPS) to ascertain the efficacy of this treatment. The average duration of follow-up for this population was 77 months (median, 47 months), with a range of 21 to 278 months. A functioning LPS was successful in alleviating symptoms in all patients studied, and no patient with a functioning shunt complained of shunt-related symptoms, such as low-pressure headache or abdominal pain, within 2 months after the shunt was performed. Twelve patients (44%) required no revisions. The number of revisions among the 15 patients (56%) who required them ranged from 1 (5 patients) to 13 (1 patient). Three of these patients required 35 of the 66 total shunt revisions (53%). There were no major complications from LPS, other than failure of the shunt, even in patients who required multiple shunts. We conclude that placement of a lumboperitoneal shunt is satisfactory treatment for the majority of patients with PTC who require surgical therapy for the disorder, even though some patients ultimately require multiple shunt revisions.
我们对27例接受至少一次腰大池-腹腔分流术(LPS)治疗的假性脑瘤(PTC)患者进行了一项回顾性研究,以确定该治疗方法的疗效。该人群的平均随访时间为77个月(中位数为47个月),范围为21至278个月。在所有研究患者中,正常工作的LPS成功缓解了症状,并且在分流术后2个月内,没有使用正常工作分流装置的患者抱怨出现与分流相关的症状,如低压性头痛或腹痛。12例患者(44%)无需进行分流装置的修订。在需要修订的15例患者(56%)中,修订次数从1次(5例患者)到13次(1例患者)不等。其中3例患者需要进行66次总分流装置修订中的35次(53%)。除了分流装置失灵外,LPS没有导致其他严重并发症,即使是那些需要多次分流的患者。我们得出结论,对于大多数因该疾病需要手术治疗的PTC患者而言,腰大池-腹腔分流术是一种令人满意的治疗方法,尽管有些患者最终需要多次修订分流装置。