外伤后脑积水患者的病例报告:脑室-囊泡分流术并文献复习。

Q3 Medicine Korean Journal of Neurotrauma Pub Date : 2023-09-25 eCollection Date: 2023-09-01 DOI:10.13004/kjnt.2023.19.e52
Gyubin Lee, Kum Whang, Sungmin Cho, Jongyeon Kim, Byeongoh Kim, Yeongyu Jang, Jongwook Choi
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摘要

创伤后脑积水(PTH)通过脑脊液(CSF)分流治疗,通常通过脑室-腹腔分流(VPS)或其他分流技术。由于这些分流与某些人群的严重并发症和高翻修率有关,因此根据患者的病史和并发症定制分流程序很重要。在此,我们报告一名30岁男子在摩托车上发生交通事故后PTH的病例。选择VPS作为治疗方法,但由于术后感染、分流梗阻和腹部问题等持续并发症,需要多次翻修和更换。由于患者的心力衰竭和胸腔积液导致心室-胸膜和心室-心房分流术不可行,因此决定与泌尿科医生合作,将分流术转移到膀胱(心室-囊泡分流术[VVS])。大约3个月后的随访检查显示,心室大小缩小,脑积水改善,没有出现泌尿系统感染或膀胱结石形成等并发症。如果患者的潜在疾病,如心力衰竭和胸腔积液,使其不适合选择胸膜腔或心房作为非腹膜腔,当先前的VPS出现并发症时,VVS可能是连续CSF引流的合适选择。
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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Case Report of a Post-Traumatic Hydrocephalus Patient: Ventriculo-Vesicle Shunt With a Review of the Literature.

Post-traumatic hydrocephalus (PTH) is treated through cerebrospinal fluid (CSF) diversion, typically through ventriculoperitoneal shunt (VPS) or other bypass techniques. As these shunts are associated with significant complications and high revision rates in certain populations, it is important to tailor a patient's shunt procedure according to their medical history and complications. Herein, we report the case of a 30-year-old man with PTH following a traffic accident on a motorcycle. VPS was chosen as the method of treatment but required multiple revisions and replacements due to persistent complications such as post-operative infection, shunt obstruction and abdominal problem. As the patient's heart failure and pleural effusion rendered both ventriculopleural and ventriculoatrial shunt not feasible, it was decided to move the shunt to the bladder (ventriculo-vesicle shunt [VVS]) in cooperation with a urologist. Follow-up examinations after about 3 months showed a decrease in ventricle size, improved hydrocephalus, and no complications such as urinary infection or bladder stone formation. In cases where the patient's underlying conditions, such as heart failure and pleural effusion, make it unsuitable to choose the pleural cavity or atrium as non-peritoneal spaces, VVS can be a suitable option for continuous CSF drainage when complications have occurred with the previous VPS.

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