CEREBROSPINAL-FLUID EDEMA ASSOCIATED WITH SHUNT OBSTRUCTION
CEREBROSPINAL-FLUID EDEMA ASSOCIATED WITH SHUNT OBSTRUCTION
复制标题
DOI：
10.3171/jns.1994.81.2.0179
复制
发表时间：
1994-08-01
影响因子：
4.1
通讯作者：
HAKUBA, A
中科院分区：
文献类型：
--
作者：
SAKAMOTO, H;FUJITANI, K;HAKUBA, A
作者报告了4例脑积水患儿，脑脊液（CSF）水肿沿着脑室导管延伸至梗阻的CSF分流管。其中3例患者表现出沿脑室导管沿着的大量CSF水肿，尽管脑室内压升高，但他们既没有表现出脑室扩大，也没有表现出明显的脑室周围CSF水肿。这些结果提示心室紧张。另1例患者脑室扩张伴脑室周围CSF水肿，沿脑室导管沿着有限区域出现CSF水肿。更换阻塞的腹膜导管的分流导致迅速改善水肿的所有患者。然而，在3例出现大量CSF水肿的患者中，分流系统翻修术后3 - 5年，计算机断层扫描和/或磁共振成像显示，沿着脑室导管的皮质下白色中仍存在小病变。得出的结论是，分流管阻塞可能会导致脑积水儿童沿着脑室导管出现大量CSF水肿，这些儿童在安装分流管后出现心室紧张，对脑部受影响区域造成不可逆转的（尽管通常无症状）损伤。
The authors report four hydrocephalic children with cerebrospinal fluid (CSF) edema extending along the ventricular catheter of an obstructed CSF shunt. Three of the patients exhibited massive CSF edema along the ventricular catheter, yet they manifested neither ventricular enlargement nor apparent periventricular CSF edema despite increased intraventricular pressure. These findings suggested ventricular tautness. The remaining patient, who had dilated ventricles with periventricular CSF edema, displayed CSF edema in a limited area along the ventricular catheter. Replacement of the obstructed peritoneal catheter of the shunt resulted in rapid improvement of the edema in all patients. In the three patients with massive CSF edema, however, a small lesion remained in the subcortical white matter along the ventricular catheter as demonstrated by computerized tomography and/or magnetic resonance imaging 3 to 5 years after shunt revision. It is concluded that shunt obstruction may result in massive CSF edema along the ventricular catheter in hydrocephalic children who have ventricular tautness after installation of the shunt causing irreversible although usually asymptomatic damage to the affected area of the brain.