Van Bogaert P, Raftopoulos C, Cordonnier M, Chaskis C, Szliwowski H B
Department of Neurology (Pediatric Neurology), Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Childs Nerv Syst. 1996 May;12(5):276-8; discussion 279. doi: 10.1007/BF00261810.
A 6.5-year-old child who received a shunt at 3 weeks of age for triventricular hydrocephalus related to his congenital toxoplasmosis developed symptoms of intracranial hypertension and papilloedema. Computed tomographic scan demonstrated slit ventricles. The shunt device was shown to be patent on isotope transit study. Spontaneously the cranial sutures widened and headaches disappeared, but loss of vision occurred and did not reverse despite optic nerve sheath fenestration. We suspect that a rapid drop in intracranial pressure played a role in the pathogenesis of our patient's blindness. This possible complication should be taken into account when calvarial expansion is planned in a patient with an intracranial hypertension syndrome with papilloedema in the presence of slit ventricles and a patent shunt.
一名6.5岁儿童在3周龄时因先天性弓形虫病导致的三脑室脑积水接受了分流手术，之后出现了颅内高压和视乳头水肿的症状。计算机断层扫描显示脑室狭小。同位素通过研究表明分流装置通畅。颅骨缝自发增宽，头痛消失，但出现了视力丧失，尽管进行了视神经鞘开窗术，视力仍未恢复。我们怀疑颅内压的快速下降在该患者失明的发病机制中起了作用。对于存在脑室狭小和分流装置通畅且伴有视乳头水肿的颅内高压综合征患者，在计划进行颅骨扩张时应考虑到这种可能的并发症。
