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首页> 外文期刊>Neurosurgical focus >Cerebral venous overdrainage: an under-recognized complication of cerebrospinal fluid diversion
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Cerebral venous overdrainage: an under-recognized complication of cerebrospinal fluid diversion

机译：脑静脉溢出：脑脊液导流的公认并发症

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Understanding the altered physiology following cerebrospinal fluid (CSF) diversion in the setting of adult hydrocephalus is important for optimizing patient care and avoiding complications. There is mounting evidence that the cerebral venous system plays a major role in intracranial pressure (ICP) dynamics especially when one takes into account the effects of postural changes, atmospheric pressure, and gravity on the craniospinal axis as a whole. An evolved mechanism acting at the cortical bridging veins, known as the "Starling resistor," prevents overdrainage of cranial venous blood with upright positioning. This protective mechanism can become nonfunctional after CSF diversion, which can result in posture-related cerebral venous overdrainage through the cranial venous outflow tracts, leading to pathological states. This review article summarizes the relevant anatomical and physiological bases of the relationship between the craniospinal venous and CSF compartments and surveys complications that may be explained by the cerebral venous overdrainage phenomenon. It is hoped that this article adds a new dimension to our therapeutic methods, stimulates further research into this field, and ultimately improves our care of these patients.
机译：了解在成人脑积水的设置中脑脊液（CSF）转移后的改变的生理学对于优化患者护理并避免并发症是重要的。有证据表明脑静脉系统在颅内压（ICP）动态中起主要作用，特别是当人们考虑到整个颅轴蠕动轴的姿势变化，大气压和重力的影响时。一种演进的机制，其在皮质桥接静脉上，称为“椋鸟电阻”，防止过升降的脑血管血液直立定位。在CSF转移后，这种保护机制可能变得无官能，这可能导致通过颅骨流出束的姿势相关的脑静脉溢出，导致病理状态。本综述文章总结了颅静脉和CSF隔室之间关系的相关解剖和生理基础，并调查了可以通过脑静脉溢出现象解释的并发症。希望本文为我们的治疗方法增加了新的维度，刺激进一步研究该领域，最终改善了我们对这些患者的照顾。

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