Abtin K, Thompson B G, Walker M L
Department of Neurological Surgery, University of Utah, Primary Children's Medical Center, Salt Lake City 84113, USA.
Pediatr Neurosurg. 1998 Jan;28(1):35-41. doi: 10.1159/000028616.
The morbidity and mortality associated with third ventriculostomy has decreased significantly over the past 75 years since its introduction by Walter Dandy. Now more commonly performed using an endoscopic method, the significant morbidity of third ventriculostomy has dropped to approximately 5%; essentially that associated with ventriculoscopy in general. However, the possible complication of massive subarachnoid hemorrhage resulting from perforation of the basilar artery or its branches in the course of fenestration of the floor of the third ventricle has only recently been reported. In our case, subsequent to a vascular injury, a pseudoaneurysm developed at the site of vascular perforation, which was then appropriately controlled. The patient has since made a full recovery. Our goal is to remind the endoscopist of this unusual complication and to discuss our management strategies.
自沃尔特·丹迪引入第三脑室造瘘术以来的75年里，与之相关的发病率和死亡率已显著下降。如今，第三脑室造瘘术更常采用内镜方法进行，其显著的发病率已降至约5%；基本上与一般的脑室镜检查有关。然而，第三脑室底部开窗过程中基底动脉或其分支穿孔导致大量蛛网膜下腔出血的可能并发症直到最近才被报道。在我们的病例中，血管损伤后，在血管穿孔部位形成了一个假性动脉瘤，随后得到了适当的控制。患者此后已完全康复。我们的目的是提醒内镜医师注意这种不寻常的并发症，并讨论我们的处理策略。
