Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction.
Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction.
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DOI：
10.4103/1793-5482.179643
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Tanaka S
中科院分区：
文献类型：
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作者：
Ohya J;Chikuda H;Nakatomi H;Sakamoto R;Saito N;Tanaka S
梗阻性脑积水是一种罕见的并发症后，大孔减压Chiari畸形。然而，由于颅椎交界处（CVJ）的其他病变，脊柱手术后梗阻性脑积水的报道很少。作者在此报告一位52岁的女性软骨发育不全，表现为8个月的脊髓病史，原因是脊髓压迫在CVJ。切除C1后弓和部分枕骨边缘。术后1周的CT扫描显示双侧幕下积液。患者首先接受保守治疗；然而，在第17天，她的意识水平突然恶化。急诊CT显示明显的脑积水，由于大脑导水管阻塞。急性梗阻性脑积水可在CVJ减压手术后晚期发生，因此应纳入精神状态恶化的鉴别诊断。
Obstructive hydrocephalus has been described as a rare complication following foramen magnum decompression for Chiari malformation. However, there are few reports of obstructive hydrocephalus after spinal surgery for other pathologies of the craniovertebral junction (CVJ). The authors herein report a 52-year-old female with achondroplasia presenting with an 8-month history of myelopathy due to spinal cord compression at CVJ. She underwent resection of the C1 posterior arch and part of the edge of the occipital bone. A computed tomography (CT) scan obtained 1-week after the surgery revealed bilateral infratentorial fluid collection. The patient was first managed conservatively; however, on the 17th day, her consciousness level showed sudden deterioration. Emergency CT demonstrated marked hydrocephalus due to obstruction of the cerebral aqueduct. Acute obstructive hydrocephalus can occur late after decompression surgery at the CVJ, and thus should be included in the differential diagnosis of a deteriorating mental status.