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首页> 美国卫生研究院文献>Croatian Medical Journal >The effects of lumboperitoneal and ventriculoperitoneal shunts on the cranial and spinal cerebrospinal fluid volume in a patient with idiopathic intracranial hypertension
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The effects of lumboperitoneal and ventriculoperitoneal shunts on the cranial and spinal cerebrospinal fluid volume in a patient with idiopathic intracranial hypertension

机译：腰腹和脑腹膜分流对特发性颅内高压患者颅脑和脊髓脑脊液量的影响

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Lumboperitoneal (LP) and ventriculoperitoneal (VP) shunts are a frequent treatment modality for idiopathic intracranial hypertension (IIH). Although these shunts have been used for a long time, it is still not clear how they change the total craniospinal CSF volume and what portions of cranial and spinal CSF are affected. This report for the first time presents the results of a volumetric analysis of the total cranial and spinal CSF space in a patient with IIH. We performed an automated segmentation of the cranial and a manual segmentation of the spinal CSF space first with an LP shunt installed and again after the LP shunt was replaced by a VP shunt. When the LP shunt was in place, the total CSF volume was smaller than when the VP shunt was in place (222.4 cm3 vs 279.2 cm3). The difference was almost completely the result of the spinal CSF volume reduction (49.3 cm3 and 104.9 cm3 for LP and VP, respectively), while the cranial CSF volume was not considerably altered (173.2 cm3 and 174.2 cm3 for LP and VP, respectively). This report indicates that LP and VP shunts in IIH do not considerably change the cranial CSF volume, while the reduction of CSF volume after LP shunt placement affects almost exclusively the spinal part of the CSF system. Our results suggest that an analysis of both the cranial and the spinal part of the CSF space is necessary for therapeutic procedures planning and for an early recognition of numerous side effects that often arise after shunts placement in IIH patients.
机译：腰腹（LP）和脑室腹腔（VP）分流术是特发性颅内高压（IIH）的常见治疗方式。尽管这些分流器已使用了很长时间，但仍不清楚它们如何改变颅脑脊液的总体积以及颅脑和脊柱CSF的哪些部分受到影响。该报告首次介绍了IIH患者的总颅脑和脊髓CSF空间的体积分析结果。我们首先对颅骨进行自动分割，对脊柱CSF腔进行手动分割，首先安装了LP分流器，然后再将LP分流器替换为VP分流器。当使用LP分流器时，总的CSF体积要比使用VP分流器时小（222.4 cm 3 对279.2 cm 3 ）。差异几乎完全是脊柱CSF体积减少的结果（LP和VP分别为49.3 cm 3 和104.9 cm 3 ），而颅脑CSF体积却没有发生了很大变化（LP和VP分别为173.2 cm 3 和174.2 cm 3 ）。该报告表明，IIH中的LP和VP分流不会显着改变颅脑CSF体积，而LP分流放置后CSF体积的减少几乎仅影响CSF系统的脊柱部分。我们的研究结果表明，对于治疗程序的规划以及早期识别IIH患者分流后经常出现的许多副作用，必须对CSF空间的颅骨和脊椎部分进行分析。

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