PDF(Pubmed)
Abstract：
Introduction Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid within the brain\'s ventricular system. It can stem from obstructive and nonobstructive causes. Pregnancy introduces physiopathological changes that may heighten the risk of developing or worsening symptomatic hydrocephalus. Nevertheless, comprehensive reports on this aspect, especially regarding surgical interventions, remain scarce. Case Report A young woman with a history of recurrent headaches experienced a worsening of her symptoms at the onset of her pregnancy. A magnetic resonance imaging (MRI) in the first trimester revealed increased ventricular dilation, indicating an obstructive cause due to aqueduct stenosis. During a neurosurgical board meeting, treatment options were discussed, considering the identifiable obstruction, the heightened intra-abdominal pressure associated with pregnancy, and the risk of ventricular shunt dysfunction. The patient underwent an endoscopic third ventriculostomy (ETV) without complications, leading to both symptom relief and a successful conclusion to the pregnancy. Discussion Neurosurgical procedures in pregnant women are uncommon due to the increased risks to both the mother and the fetus. However, when performed by a qualified multidisciplinary team, they can lead to positive outcomes. In cases of hydrocephalus during pregnancy, ETV appears to be a viable alternative for surgical intervention, particularly when hydrocephalus becomes symptomatic and an obstructive cause is identified, whether in patients with existing shunts or those with newly developed hydrocephalus.
摘要：
引言脑积水是一种以脑室系统内脑脊液异常积聚为特征的疾病。它可以源于阻塞性和非阻塞性原因。妊娠会引起病理生理变化，可能会增加发生或恶化症状性脑积水的风险。然而，这方面的全面报道，特别是关于外科手术，保持稀缺。病例报告一名有反复头痛病史的年轻女性在怀孕开始时症状恶化。前三个月的磁共振成像（MRI）显示心室扩张增加，提示导水管狭窄引起的阻塞.在神经外科委员会会议上，讨论了治疗方案，考虑到可识别的障碍物，与怀孕相关的腹内压力升高，和心室分流功能障碍的风险。患者接受了内镜下第三脑室造瘘术（ETV），无并发症，导致症状缓解和成功怀孕。讨论由于对母亲和胎儿的风险增加，孕妇的神经外科手术很少见。然而,由合格的多学科团队执行时，它们可以带来积极的结果。在怀孕期间脑积水的情况下，ETV似乎是手术干预的可行替代方案，特别是当脑积水出现症状并被确定为阻塞性病因时，无论是现有分流患者还是新发展的脑积水患者。
