オンマヤリザーバー設置術・脳室ドレナージ術

Ommaya Reservoir and the External Ventricular Drainage

Point

・オンマヤリザーバー設置術および脳室ドレナージ術は，一時的水頭症治療の代表的手技である．

・オンマヤリザーバー設置術の対象病態には，未熟児脳室内出血や脊髄髄膜瘤に伴う水頭症などがあり，髄注薬剤の投与経路として用いられることもある．

・脳室ドレナージ術の対象病態には，脳腫瘍などで急性水頭症を来した場合や，頭蓋内圧管理を要する重症頭部外傷などがある．

　Childhood hydrocephalus is a highly diverse disease caused by various factors, and most surgical treatments are performed during infancy. Despite the diversity of hydrocephalus pathologies, treatment options are limited. It is difficult for pediatric neurosurgeons to select and perform appropriate surgical procedures for neonates and infants.

　Treatment options for hydrocephalus are broadly divided into permanent and temporary. Permanent treatments include cerebrospinal fluid shunt and endoscopic third ventriculostomy; temporary treatment entails cerebrospinal fluid drainage using lumbar puncture and intermittent cerebrospinal fluid drainage with an Ommaya reservoir, ventricular drainage, and ventriculosubgaleal shunt. This article describes in detail Ommaya reservoir placement and ventricular drainage as representative procedures for temporarily treating hydrocephalus.