Usage of neuronavigation system to treat a case of traumatic acute subdural hematoma after two-side ventriculoperitoneal shunt  

作　　者：Kun Wang Xueying Xu Huanjiang Niu Xiujun Cai Yirong Wang 

机构地区：[1]Department of Neurosurgery,Xiasha Campus,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310020,China [2]Department of Neurosurgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China [3]Department of General Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China

出　　处：《Laparoscopic, Endoscopic and Robotic Surgery》2019年第1期18-20,共3页腔镜、内镜与机器人外科（英文）

基　　金：This work was supported by the Program for Health and Family Planning Commission of Hangzhou Municipality,China(2017A73);Medicine and Health Science and Technology Projects of Zhejiang Province,China(2018270408);National Natural Science Foundation of China(81402044);Natural Science Foundation of Zhejiang Province of China(LY14H160017,LY14H160025).

摘　　要：Traumatic acute subdural hematoma is one of the most lethal causes of head injuries,which leads to high mortality.While combined diseases always make it more intractable for the treatment.We present a case of a 68-year-old female patient with traumatic acute subdural hematoma combined with hydrocephalus after ventriculoperitoneal shunt assisted by the neuronavigation system in January 12,2017.She was undergone ventriculoperitoneal shunt 6 years and 5 months ago on two sides respectively because of hydrocephalus,with the ventriculoperitoneal shunt device on the right side out of work.The initial neurological examination showed a Glasgow Coma Scale of E2V1M5 with no papillary defect.A CT scan of the head revealed a left homogeneously hyperdense and subdural hematoma,with compression of the lateral ventricle(2.6 cm thick)and a 0.5 cm midline shift.To protect the ventriculoperitoneal shunt device,we used neuronavigation system to precisely mark the relative location of the device and“invisible”subdural hematoma,thus to design a perfect incision preoperatively.Subsequently,evacuation of the subdural hematoma was performed via craniotomy without damaging the ventriculoperitoneal shunt device.Postoperative CT of the head showed totally removing of the subdural hematoma.The patient recovered three months later.With the assistant of neuronavigation system,it is much easier for the preoperative planning and to reduce the surgical risk.Our case gives a clue that more approaches can be considered when encountering acute head trauma with the complicated combined diseases.

关 键 词：NEURONAVIGATION Acute subdural hematoma HYDROCEPHALUS Ventriculoperitoneal shunt 

分 类 号：R65[医药卫生—外科学]