由于阴性胸内压力,心室关节的脑内迁移是由于阴性胸内压力
Siddharth Srinivasan1, Yasaswi Kanneganti1, Rajesh Nair1
1Department of Neurosurgery, Kasturba Medical College and Hospital, Udupi, Karnataka, India.
Asian journal of neurosurgery
|August 29, 2024
概括
延迟的远距离突变尖端迁移到胸腔是一个罕见的并发症 腹腔关节 (VP) 突变 在婴儿中. 这一案例凸显了阴性胸内压力如何导致逐渐的分流迁移,导致膜溢出和呼吸困难.
科学领域:
- 神经外科 神经外科
- 儿科手术 儿科手术
- 放射学 放射学是一门学科.
背景情况:
- 腹腔皮管 (VP) 突变是先天性阻塞性水脑病的标准治疗方法,特别是婴儿的水道狭窄症.
- 斜迁移是一种已知的并发症,但延迟的远端斜尖迁移到胸腔是罕见的.
- 阴性胸内压力是这种延迟迁移的可疑机制.
研究的目的:
- 报告一个罕见的婴儿偏远心室上突变迁移到胸腔的延迟病例.
- 讨论这种并发症的潜在机制和临床影响.
- 提高医疗保健专业人员对这种罕见但严重的VP分流并发症的认识.
主要方法:
- 一名患有阻塞性水脑症的1岁婴儿用VP分离器治疗的案例报告.
- 临床表现的详细描述,神经成像发现 (MRI) 和手术干预.
- 手术后的随访包括胸部X光学图和CT胸部,以诊断分流迁移和多叶流液.
- 修复手术的描述和像CSF水胸这样的并发症的管理.
主要成果:
- 婴儿出现了脑内压力升高的症状,并接受了VP分流装置的安置.
- 术后3个月,婴儿患有呼吸障碍,原因是 complete shunt 迁移到右侧腔空间,并有显著的输液.
- CT成像表明,在最初的手术期间,皮下道道形成,由于负的胸内压力而逐渐迁移.
- 修复手术成功地重新定位了分流器,患者通过临时通风和胸管排水恢复了健康.
结论:
- 延迟的VP分流器进入胸腔的膜上迁移可能会随着时间的推移缓慢地发生,这是由于负的胸内压力.
- 这种并发症可能导致显著的发病率,包括肺溢液和呼吸困扰.
- 神经外科医生,儿科医生和重症监护医生应该对这种罕见的并发症保持警,并在患有VP短路患者的呼吸系统症状的差异诊断中考虑它.
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