脑室腹腔分流器放置后14年延迟发作的脑气:说明性病例。

Saori Ueda, Katsuya Ueno, Haruna Isozaki, Yi Li, Junichi Takeda, Masahiro Nonaka
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引用次数: 0

摘要

背景:脑气是创伤或头部手术的一种已知并发症,通常发生在受伤后48小时内。然而,文献中很少记载迟发性气脑。在这里,作者报告了一例脑室-腹膜(VP)分流放置治疗创伤后脑积水14年后发生的脑气。观察:一名16岁的女孩,颅底骨折,包括左岩性骨折,弥漫性脑损伤,2岁时因交通事故引起的蛛网膜下腔出血,在受伤1个月后接受了VP分流术治疗外伤性脑积水。分流手术14年后,她突然头痛,被诊断为脑气。CT显示左侧明显的气颅。虽然无法确定确切的空气进入点,但在调整Strata II分流阀压力设置后,患者的病情有所改善。最终,分流器被移除以防止进一步感染。未见脑脊液漏,患者无症状复发。经验教训:有VP分流术和颅底骨折史的患者即使在长时间后也可能发展为脑气。https://thejns.org/doi/10.3171/CASE25118。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Delayed onset of pneumocephalus 14 years after ventriculoperitoneal shunt placement: illustrative case.

Background: Pneumocephalus is a known complication of trauma or head surgery, typically occurring within 48 hours of injury. However, delayed-onset pneumocephalus has been rarely documented in the literature. Here, the authors report a case of pneumocephalus that developed 14 years after ventriculoperitoneal (VP) shunt placement for posttraumatic hydrocephalus.

Observations: A 16-year-old girl with a history of skull base fracture, including a left petrous bone fracture, diffuse brain injury, and subarachnoid hemorrhage caused by a traffic accident at 2 years of age, underwent VP shunt placement for posttraumatic hydrocephalus 1 month after the injury. Fourteen years after the shunt surgery, she developed a sudden headache and was diagnosed with pneumocephalus. CT imaging revealed significant left-sided pneumocephalus. Although the exact point of air entry was not identified, her condition improved following adjustments to the Strata II shunt valve pressure settings. Eventually, the shunt was removed to prevent further infections. No CSF leakage was observed, and the patient experienced no recurrence of symptoms.

Lessons: Patients with a VP shunt and a history of skull base fracture may develop pneumocephalus even after a prolonged period. https://thejns.org/doi/10.3171/CASE25118.

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