脳室腹腔短絡術後にcerebrospinal fluid edemaを来した正常圧水頭症の3例

Cerebrospinal Fluid Edema Occurred in Normal Pressure Hydrocephalic Patients with Functioning Ventriculo-peritoneal Shunts: Report of Three Cases

Ⅰ．はじめに

　水頭症に対して行われる脳室腹腔短絡術に代表されるシャント術では，ときに種々の合併症を来すことがあるが，そのなかで脳室カテーテルに沿って髄液が脳実質内に浸潤するcerebrospinal fluid edema（CFE）は非常に稀な合併症である．しかも，CFEの過去の報告例はほとんどがシャント不全に続発したものであり，シャントが機能している状態でのCFEの発生例の報告は渉猟した限りでは見当たらない^1-4)．

　今回，シャントは機能しているにもかかわらず，CFEを来した正常圧水頭症の3例を経験したので，若干の文献的考察を加え報告する．

　We describe three cases of cerebrospinal fluid edema (CFE) which occurred in hydrocephalic adult patients who underwent ventriculo-peritoneal shunt operations. After shunt operations,the shunt systems were functioning well and symptoms due to hydrocephalus were resolved. However,computed tomographic scans demonstrated CFE around the ventricular catheters in all patients. The patients were free from symptoms due to CFE and observed conservatively. The one-way valve mechanism is thought to be a possible mechanism of CFE in these cases. Although CFE is a very rare complication to occur after shunt operations,it is necessary to follow up the patients even if the shunt is functioning well.