特発性正常圧水頭症に対する脳室腹腔シャント術後に気脳症を呈した1例

Pneumocephalus following ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus：a case report

水頭症に対する脳室腹腔シャント術（ventriculoperitoneal shunt：VPS）に続発する気脳症はこれまでいくつか報告されている^1-7）。シャント術前に気脳症発症を予期することは難しく，気脳症治療の際にシャント機能の犠牲を余儀なくされる場合がある。

Pneumocephalus has been reported as a surgical complication following placement of a ventriculoperitoneal shunt（VPS）. We report here the case of a 79-year-old woman with pneumocephalus following VPS for idiopathic normal pressure hydrocephalus. Discontinuity of the skull base and lowering of the intracranial pressure for VPS are background factors. Thin-slice bone CT reveals the air entry points, and surgical closure of the fistula could be effective. As predicting this complication preoperatively is sometimes difficult, early diagnosis is essential. Careful control of shunt pressure is important for preventing pneumocephalus in addition to radiological examination. Characteristic sounds could enable early diagnosis of pneumocephalus following VPS.