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Journal of Neurosurgical Sciences 2002 Dicembre;46(3-4):120-1

lingua: Inglese

Symptomatic sub­du­ral hygro­ma ­after pet­ro­cli­val menin­gio­ma sur­gery. Case illus­tra­tion of a intract­able com­pli­ca­tion

Zingale A., Fagone S., Albanese V.

Department of Neurosurgery, “Garibaldi Hospital”, Catania, Italy


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Although sub­du­ral hygro­ma devel­op­ment ­after cran­i­ot­o­my or aneu­rysm sur­gery is a ­well-­known com­pli­ca­tion and sub­du­ral per­i­to­neal or V-P ­shunt are com­mon­ly suc­cess­ful pro­ce­dures, ­there are sit­u­a­tions ­that can­not be treat­ed by avail­able sur­gi­cal ­options. We report­ed a ­case of a 28-­year-old ­young man who devel­oped a symp­to­mat­ic sub­du­ral hygro­ma ­after remov­al of pet­ro­cli­val menin­gio­ma. This hygro­ma ­increased in ­size and ­became bilat­er­al in ­spite of implan­ta­tion of V-P ­with pro­gram­mable ­valve at ­open pres­sure var­i­able ­from 30 to 180 mmH2O, place­ment of sub­du­ral-per­i­to­neal ­shunt ­with low-low ­valve or with­out ­valve and exter­nal diver­sion. The occur­rence of ­this ­case ­showed ­that ­there oth­er fac­tors can ­play ­role in hygro­ma devel­op­ment as dis­tur­bance of nor­mal CSF dynam­ic ­with ­shunt of CSF ­from ­basal arach­noid­al to sub­du­ral spac­es sec­on­dary to sur­gery and/or ­slow ­growth of pet­ro­cli­val menin­gio­ma as ­well as post­op­er­a­tive pro­gres­sive cere­bral atro­phy. Actually ­there are not effec­tive diag­nos­tic ­tools to ­detect caus­es and there­fore, ­there are restrict­ed ther­a­peu­tic pos­sibil­ities. This poten­tial and seri­ous com­pli­ca­tion ­should be ­always con­sid­ered ­when plan­ning pet­ro­cli­val menin­gio­ma sur­gery ­because of the ­severe con­se­quenc­es on func­tion­al out­come.

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