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颅内动脉瘤夹闭术后硬膜下积液合并脑积水的治疗

Treatment of subdural effusion with hydrocephalus after ruptured intracranial aneurysm clipping.

作者信息

Kawaguchi T, Fujita S, Hosoda K, Shibata Y, Komatsu H, Tamaki N

机构信息

Department of Neurosurgery, Hyogo Brain and Heart Center at Himeji, Japan.

出版信息

Neurosurgery. 1998 Nov;43(5):1033-9. doi: 10.1097/00006123-199811000-00017.

Abstract

OBJECTIVE

This study was conducted to determine whether a ventriculoperitoneal shunt alone was effective in treating subdural effusion with hydrocephalus.

METHODS

Using only a ventriculoperitoneal shunt, we successfully treated eight patients who had subdural effusion with hydrocephalus after ruptured intracranial aneurysmal clipping, despite ventricular deformity and midline shift.

RESULTS

For all of the patients, both the subdural effusion and ventriculomegaly subsided and clinical symptoms lessened after surgery.

CONCLUSION

Ventriculoperitoneal shunting alone is an effective and satisfactory procedure; no subdural peritoneal shunt is needed for patients with subdural effusion accompanied by hydrocephalus. To-and-fro communication between the subdural effusion and ventricles is considered to be present in these patients. When selecting the treatment for subdural effusion, it is important to consider whether hydrocephalus (disturbance of cerebrospinal fluid circulation) is present.

摘要

目的

本研究旨在确定单纯脑室腹腔分流术治疗硬膜下积液合并脑积水是否有效。

方法

尽管存在脑室畸形和中线移位,但仅通过脑室腹腔分流术,我们成功治疗了8例颅内动脉瘤夹闭术后出现硬膜下积液合并脑积水的患者。

结果

所有患者术后硬膜下积液和脑室扩大均消退,临床症状减轻。

结论

单纯脑室腹腔分流术是一种有效且令人满意的手术方法;硬膜下积液合并脑积水的患者无需行硬膜下腹腔分流术。这些患者被认为存在硬膜下积液与脑室之间的往返交通。在选择硬膜下积液的治疗方法时,考虑是否存在脑积水(脑脊液循环障碍)很重要。

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