neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2020-22-4-74-82neurosurgery-964Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEСупраселлярная киста после субарахноидально-вентрикулярного кровоизлияния и имплантации вентрикулоперитонеального шунта (клиническое наблюдение)Suprasellar cyst after subarachnoid intraventricular hemorrhage and ventriculoperitoneal shunt implantationhttps://orcid.org/0000-0001-8651-9986ГодковИ. М.GodkovI. M.

Иван Михайлович Годков

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

i.godkov@yandex.ruhttps://orcid.org/0000-0003-0007-8054СтепановВ. Н.StepanovV. N.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0003-3515-8329ГриньА. А.GrinA. A.

129090 Москва, Большая Сухаревская пл., 3; 127473 Москва, ул. Делегатская, 20, стр. 1

3 Bolshaya Sukharevskaya Sq., Moscow 129090; Bld. 1, 20 Delegatskaya St., Moscow 127473

ГБУЗ Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. МосквыРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian FederationГБУЗ Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы; ФГБОУ ВО Московский государственный медико-стоматологический университет им. А. И. Евдокимова Минздрава РоссииРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare Department; A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian Federation2020170120212247482Copyright © Годков И.М., Степанов В.Н., Гринь А.А., 20212021Годков И.М., Степанов В.Н., Гринь А.А.Godkov I.M., Stepanov V.N., Grin A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/964

Цель работы — представить редкое клиническое наблюдение: пациентка с супраселлярной кистой, сформировавшейся после вентрикулоперитонеального шунтирования.

Материалы и методы

Материалы и методы. Пациентка, 51 года, перенесла нетравматическое субарахноидально-вентрикулярное кровоизлияние, острую окклюзионную, затем дизрезорбтивную гидроцефалию, что потребовало имплантации вентрикулоперитонеального шунта. В течение нескольких лет у больной сформировалась супраселлярная арахноидальная киста, проявившаяся общемозговой симптоматикой.

Результаты

Результаты. Пациентке проведены две операции. В ходе первого хирургического вмешательства выполнена эндоскопическая вентрикулокистостомия с положительным эффектом, полным регрессом симптомов. Через 6 мес верифицирован рецидив кисты, и больной выполнены эндоскопическая вентрикулокистоцистерностомия и замена помпы вентрикулоперитонеального шунта низкого давления на помпу среднего давления. Достигнуто полное разрешение неврологических расстройств, при магнитно-резонансной томографии через 6 мес рецидив кисты не обнаружен.

Заключение

Заключение. Данное клиническое наблюдение расширяет представления о многообразии механизмов формирования супраселлярных арахноидальных кист и демонстрирует один из возможных путей решения проблемы формирования кисты на фоне вентрикуло-перитонеального шунтирования.

The objective is to describe a rare clinical case of a suprasellar cyst formed after implantation of a ventriculoperitoneal shunt.

Clinical observation

Clinical observation. A female patient, 51 years, suffered non-traumatic subarachnoid intraventricular hemorrhage, acute obstructive and subsequently normal pressure hydrocephalus requiring implantation of a ventriculoperitoneal shunt. In several years, the patient developed a suprasellar cyst manifesting through cerebral symptoms.

Results

Results. Two (2) surgeries were performed. During the 1st surgical intervention, endoscopic ventriculostomy was performed with positive outcome (full regression of the symptoms). After 6 months, cyst recurrence was confirmed, and endoscopic ventriculocystocisternostomy with replacement of a low pressure pump with intermediate pressure pump was performed. Full regression of neurological disorders was observed; magnetic resonance imaging did not show cyst recurrence 6 months after the 2 nd surgery.

Conclusion

Conclusion. This clinical observation expands our knowledge on the diversity of mechanisms of suprasellar arachnoid cyst formation and demonstrated effectiveness of one of the techniques for prevention of cyst formation in the context of ventriculoperitoneal shunt.

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The authors declare that there are no conflicts of interest present.