Detection of Ventriculoperitoneal Shunt Malfunction by Radionuclide Shuntogram in a Case with Dual Lateral and Fourth Ventriculoperitoneal Shunts

腦室腹腔引流管功能失常，對因水腦症而接受腦室引流術的病人來說，是最常發生之腦神經外科手術併發症。在臨床上，通常是當病人出現神經功能變差，同時在腦斷層或磁振影像檢查中出現腦室擴大時，才能下功能失常的臆斷。即使如此，引流管的流速功能還是很難去評估。我們報告一病例，病人是腦幹四疊體腫瘤病患合併雙區間水腦症，病人在接受內視鏡第三腦室造孔術後，後續分別進行側腦室腹腔引流術及第四腦室腹腔引流術。然而二個月之後病人陸續出現嚴重的軀幹端坐失能及講話不清的現像，臨床臆斷為為第四腦室腹腔引流管有阻塞，我們於是為病人第四腦室腹腔引流管之放射核種引流管造影術，檢查結果成功發現第四腦室腹腔引流管位於劍突處呈現功能及解剖位置上的阻塞。經過腹腔端引流管重置術之後，病人恢復良好而且可以下田做農夫的工作。

關鍵字

放射核種引流管造影術；腦室腹腔引流管功能失常

並列摘要

Ventriculoperitonial shunt malfunction is one of the most common neurosurgical complications in patients receiving the ventricular shunt for the hydrocephalus. Clinically, malfunction of shunt was impressed by progressive neurological deterioration incorporated with an enlarged ventricle seen anatomically in brain computed tomography or magnetic resonance imaging. However, the function of shunt flow is difficult to estimate after the shunting. We present a case of patient of tectal tumor with double compartment hydrocephalus. The patient received both lateral and fourth ventricle peritoneal shunt after the endoscopic third ventriculostomy. Two months later, patient developed severe truncal ataxia and slur speech, and then fourth ventriculoperitoneal shunt malfunction was clinically impressed. The radionuclide shuntogram demonstrates not only functional but also anatomic location of abrupt occlusion of radiouptake on the shunting tube below the xiphoid process. The revision of the examination distal peritoneal shunting tube was performed, and the patient recovers excellently by returning to physically normal status.

並列關鍵字

Radionuclide shuntogram ； Ventriculoperitoneal shunt malfunction

國際替代計量

Detection of Ventriculoperitoneal Shunt Malfunction by Radionuclide Shuntogram in a Case with Dual Lateral and Fourth Ventriculoperitoneal Shunts

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