神经内镜下第三脑室底造瘘术治疗交通性脑积水  

Endoscopic third ventriculostomy in patients with communicating hydrocephalus

作　　者：刘华[1] 漆松涛[1] 彭玉平[1] 樊俊[1] 李伟光[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经外科杂志》2013年第4期387-389,共3页Chinese Journal of Neurosurgery

摘　　要：目的探讨神经内镜下第三脑室底造瘘术成功治疗交通性脑积水的手术机制和指征。方法回顾性分析18例神经内镜下第三脑室底造瘘术治疗交通性脑积水患者的临床资料。结果11例患者术前MRI显示第四脑室异常扩张和“喇叭形”中脑导水管出口，其中9例效果良好；另外7例无此影像学特征的均失败而需进一步行分流术。结论神经内镜下第三脑室底造瘘术是治疗部分交通性脑积水的有效手段，而近端脑池梗阻可能是其重要的作用机制。第四脑室相对第三脑室异常扩张和“喇叭形”中脑导水管出口可能是此类患者的影像学特征，可作为第三脑室底造瘘术治疗交通性脑积水的手术指征之一。Objective To explore the mechanism and indication of endoscopic third ventriculostomy in patients with communicating hydrocephalus. Methods The clinical date of 18 cases of communicating hydrocephalus treated with ETV were analyzed retrospectively. Results 11 patients＇ MRI showed abnormal enlargement of the fourth ventricle and outward expansion of the cerebral aqueduct outflow like a horn, and among these patients 9 patients obtained satisfying postoperative results. However, the other 7 patients without this imageology character required shunt insertion. Conclusions Endoscopic third ventriculostomy is an effective method for the treatment of communicating hydrocephalus, and the mechanism of proximal extraventricular intracisternal cerebrospinal fluid pathway obstruction could explain. Abnormal enlargement of the fourth ventricle and outward expansion of the cerebral aqueduct outflow like a horn in MRI may be one of the most important indication of ETV in patients with communicating hydrocephalus.

关 键 词：脑积水 神经内镜 第三脑室 

分 类 号：R651.1[医药卫生—外科学]