Case report: CSF hypotension secondary to a free syringo-subarachnoid-peritoneal shunt

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY Child's Nervous System Pub Date : 2024-09-10 DOI:10.1007/s00381-024-06613-3
Agustin Ruiz Johnson, Carlos A. Rugilo, Romina A. Argañaraz
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Abstract

Introduction

Syringomyelia is present in 40% of pediatric patients with Chiari malformation. Typically treated with posterior fossa decompression, some cases require further intervention such as syrinx shunting.

Case report

We report a 16-year-old female with Chiari type 1 malformation and syringomyelia who underwent posterior fossa decompression and subsequent free syringo-subarachnoid-peritoneal shunting. The patient developed symptoms of CSF overdrainage, and imaging indicated CSF hypotension. A distal catheter ligation temporarily improved symptoms, but eventually, a programmable ventricular shunt was necessary due to shunt dependence.

Conclusion

This case highlights the rare complication of CSF overdrainage from syrinx shunting and the importance of shunt selection considerations.

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病例报告:游离蛛网膜-蛛网膜下腔-腹腔分流术继发的脑脊液低血压
导言:40%的脊髓脊膜膨出症儿童患者患有奇拉氏畸形。通常采用后窝减压术进行治疗,但有些病例需要进一步干预,如进行鞘膜分流术。病例报告我们报告了一名患有 Chiari 1 型畸形和鞘膜积液的 16 岁女性患者,她接受了后窝减压术和随后的游离鞘膜-蛛网膜下腔-腹膜分流术。患者出现了 CSF 过度引流的症状,影像学检查显示 CSF 低血压。远端导管结扎暂时改善了症状,但最终因分流依赖性而必须进行可编程脑室分流。
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来源期刊
Child's Nervous System
Child's Nervous System 医学-临床神经学
CiteScore
3.00
自引率
7.10%
发文量
322
审稿时长
3 months
期刊介绍: The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.
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Correction: Biobank for craniosynostosis and faciocraniosynostosis, rare pediatric congenital craniofacial disorders: a study protocol. Incidence of infection rate for shunt implantation: the zero % rate is always a myth. Pediatric low-grade gliomas. Shlomi Constantini, MD, MSc. Bilateral decompressive craniectomy as a damage control strategy for a preschooler multilobar bihemispheric firearm injury: a case report and systematic review
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