New-onset hydrocephalus in an adult with cerebral palsy: A case report and review of the literature.

IF 0.8 Q4 PEDIATRICS
Jeremy Roberts, Denesh Ratnasingam, Cristina Sarmiento
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Abstract

Hydrocephalus is a common comorbidity associated with brain injuries, including cerebral palsy (CP). In CP, hydrocephalus typically presents in infancy or early childhood. This report describes a patient in their mid 20 s with mixed dyskinetic-spastic CP with adult-onset hydrocephalus of unknown cause initially presenting with new-onset bilateral lower extremity spasms. Multiple interventions were trialed, including ischial bursal steroid injections, botulinum toxin injections, trigger point injections, multiple oral medications, and physical and massage therapies without benefit. Given lack of treatment response, imaging of the neuraxis was obtained. Magnetic resonance imaging (MRI) of the brain demonstrated new diffuse moderate ventriculomegaly compared to prior MRI. Ophthalmologic evaluation demonstrated papilledema, and opening pressure on lumbar puncture was elevated to 44 mmHg H2O. The patient underwent ventriculoperitoneal shunt placement with rapid and near-resolution of their spasms and pain. This patient represents a unique case of new-onset hydrocephalus in an adult with CP. To ensure appropriate and timely diagnosis and treatment, individuals with neurologic conditions such as CP should have ongoing surveillance and comprehensive evaluation for any neurologic or functional changes, including changes in baseline tone. Future research is needed to better understand if adults with CP are at higher risk for the development of hydrocephalus in adulthood.

脑瘫成人新发脑积水:病例报告和文献综述。
脑积水是脑损伤(包括脑性瘫痪)的常见合并症。在 CP 中,脑积水通常出现在婴儿期或儿童早期。本报告描述了一名 20 多岁的混合运动障碍痉挛型 CP 患者,其成年后出现不明原因的脑积水,最初表现为新发的双下肢痉挛。患者尝试了多种干预措施,包括峡囊类固醇注射、肉毒杆菌毒素注射、扳机点注射、多种口服药物以及物理和按摩疗法,但均未见效。鉴于治疗效果不佳,患者接受了神经轴成像检查。脑部磁共振成像(MRI)显示,与之前的磁共振成像相比,新出现了弥漫性中度脑室肿大。眼科检查显示有乳头水肿,腰椎穿刺开口压升高至44 mmHg H2O。患者接受了脑室腹腔分流术,其痉挛和疼痛很快就得到了近乎完全的缓解。该患者是新发脑积水的一个独特病例。为确保适当、及时的诊断和治疗,对患有神经系统疾病(如脊髓灰质炎)的患者应进行持续监测和全面评估,以发现任何神经或功能变化,包括基线张力的变化。未来的研究需要更好地了解成年 CP 患者在成年后是否有更高的脑积水发病风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.30
自引率
5.30%
发文量
139
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