中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
6期
568-571
,共4页
方文华%黄建煌%梅文忠%林志雄%康德智
方文華%黃建煌%梅文忠%林誌雄%康德智
방문화%황건황%매문충%림지웅%강덕지
蛛网膜囊肿%囊肿-腹腔分流术%手术后并发症
蛛網膜囊腫%囊腫-腹腔分流術%手術後併髮癥
주망막낭종%낭종-복강분류술%수술후병발증
Arachnoid cyst%Cystoperitoneal shunt%Postoperative complication
目的 探讨颅内蛛网膜囊肿-腹腔分流术后并发分流管依赖的可能机制、影像学特征及治疗方法.方法 分析2例蛛网膜囊肿行囊肿-腹腔分流术后并发分流管依赖的诊治过程,并结合文献进行讨论和总结.结果 2例均表现为分流管功能丧失后继发严重颅高压症状,其中1例行侧脑室-腹腔分流术;另1例先行囊肿-腹腔分流术,1个月后分流管堵塞,改行腰大池-腹腔分流术.经治疗后2例均痊愈出院,预后良好.结论 分流管依赖是继发于分流管功能下降或丧失,临床表现呈持续进展性颅内压增高;影像学上可观察到侧脑室正常或轻度缩小,原囊肿短期内可复现增大;解除分流管梗阻或重新建立脑脊液引流渠道是安全有效的治疗方法.
目的 探討顱內蛛網膜囊腫-腹腔分流術後併髮分流管依賴的可能機製、影像學特徵及治療方法.方法 分析2例蛛網膜囊腫行囊腫-腹腔分流術後併髮分流管依賴的診治過程,併結閤文獻進行討論和總結.結果 2例均錶現為分流管功能喪失後繼髮嚴重顱高壓癥狀,其中1例行側腦室-腹腔分流術;另1例先行囊腫-腹腔分流術,1箇月後分流管堵塞,改行腰大池-腹腔分流術.經治療後2例均痊愈齣院,預後良好.結論 分流管依賴是繼髮于分流管功能下降或喪失,臨床錶現呈持續進展性顱內壓增高;影像學上可觀察到側腦室正常或輕度縮小,原囊腫短期內可複現增大;解除分流管梗阻或重新建立腦脊液引流渠道是安全有效的治療方法.
목적 탐토로내주망막낭종-복강분류술후병발분류관의뢰적가능궤제、영상학특정급치료방법.방법 분석2례주망막낭종행낭종-복강분류술후병발분류관의뢰적진치과정,병결합문헌진행토론화총결.결과 2례균표현위분류관공능상실후계발엄중로고압증상,기중1례행측뇌실-복강분류술;령1례선행낭종-복강분류술,1개월후분류관도새,개행요대지-복강분류술.경치료후2례균전유출원,예후량호.결론 분류관의뢰시계발우분류관공능하강혹상실,림상표현정지속진전성로내압증고;영상학상가관찰도측뇌실정상혹경도축소,원낭종단기내가복현증대;해제분류관경조혹중신건립뇌척액인류거도시안전유효적치료방법.
Objective To discuss the possible mechanism,imaging characteristics,and treatment of shunt dependency following cystoperitoneal shunt of the intracranial arachnoid cyst.Methods The diagnosis criteria and treatment of 2 cases of shunt dependency following the cystoperitoneal shunt of intracranial arachnoid cyst were studied,and the relative literatures were reviewed.Results The development of acute intracranial hypertension during cystoperitoneal shunt malfunction were detected in both 2 cases.One case was treated with the ventriculoperitoneal shunt.The other case first received a cystoperitoneal shunt,and then was treated with the lumbar-peritoneal shunt after a blockage of the cystoperitoneal shunt tube.After treatments,both patients were discharged with good prognosis.Conclusions The possible mechanism of shunt dependency could be described as the "disuse decline" of cerebrospinal fluid absorption.Relieving the shunt tube obstruction or re-establishment of CSF drainage channels might be the safe and effective treatment of shunt dependency.