MANAGEMENT OF CEREBROSPINAL FLUID LEAKAGE FOLLOWING CERVICAL SPINE SURGERY

Objective To investigate the management and outcome of cerebrospinal fluid leakage(CSFL)after cervical surgery.Methods Medical records of 642 patients who underwent cervical surgery between December 1999 and December 2005 at our hospital were retrospectively reviewed.Five patients complicated by CSFL after surgery were enrolled,of which 4 cases were complicated after ossified posterior longitudinal ligament or posterior vertebral osteophyte resection directly injuring the dura,and 1 case after posterior cervical double-door laminoplasty without observed dural injury during surgery.Of the 5 CSFL cases,4 cases occurred at 1-3 days after operation and 1 case at 9 days after operation.All 5 postoperative CSFL cases were treated through wound drainage removal,wound sutures,prophylactic antibiotics,and continuous subarachnoid drainage in the elevated head position.Results All 5 CSFL cases experienced leakage cessation within 1-3 days and wound healing within 4-8 days,and subarachnoid drainage lasted 11-16 days with an average volume of 320 mL(range,150-410 mL).Four cases experienced headache,nausea and vomiting,1 case suffered from somnolence and hyponatremia,and symptoms subsided after symptomatic treatment and intravenous fluid administration.All patients were followed up for an average of 32 months(range,22-50 months).No occurrence of cerebrospinal fluid cyst or wound infection was observed.CSFL produced no significant negative effects upon neuromuscular function recovery.Conclusion Continuous subarachnoid cavity drainage in combination with elevated head position is a simple and safe non-surgical method in treatment of CSFL following cervical surgery.

Individualized Sellar Floor Reconstruction Method and Nursing Strategy for the Intraoperative Cerebrospinal Fluid Leakage Caused by Neuroendoscopic Transsphenoidal Pituitary Adenoma Resection

Objective: To explore the clinical effect of and the method and nursing strategy for sellar reconstruction for intraoperative cerebrospinal fluid (CSF) leakage in pituitary adenoma resection under neuroendoscopy. Methods: The data from 20 cases of intraoperative CSF leak caused by transsphenoidal pituitary adenoma resection were retrospectively analyzed. Six patients were treated with mucosal flap and artificial dural reconstruction of sellar (simple sellar floor reconstruction). In 45 patients, autologous fat, fascia lata, and artificial dura were used to repair and reconstruct the sellar floor (multilayer sellar floor reconstruction). After the operation, all patients underwent follow-up for 6 - 24 months. Results: Fifty patients were followed up without CSF leakage. One patient was cured after leakage of CSF through the lumbar cistern 1 month after discharge. Conclusion: For patients with CSF leakage during neuroendoscopic transsphenoidal pituitary adenoma resection, individualized sellar floor reconstruction should be adopted according to the degree of CSF leakage and the size of the sellar floor defect. Strict nursing measures can effectively prevent CSF leakage and reduce postoperative complications.

Cerebrospinal fluid and neural stem cell niche control

Neurogenesis from inner brain neural stem cells （NSCs） is a process which takes place continuously in mammals through- out their life. However, the main ontogenic difference is the intensity of neurogenesis, which commences as a very intensive and global activity in the early embryonic brain （neural tube）, persists in fetal and newborn stages, and declines significantly in adulthood, becoming restricted to specific places with low neurogenic activity such as the subventricular zone （SVZ） and the subgranular zone （SGZ） in the dentate gyrus （DG） of the hippocampus.

Parallel Detection of Bacterial Pathogens in Cerebrospinal Fluid with 16S rRNA Probe Microarray

To establish the microarray technique with 16S rRNA probe for the rapid detection of pathogenic bacteria in cerebrospinal fluid, a set of Digoxin labelling universal primers were designed, and used to amplify the 16S rRNA gene, and 2 specific probes for each bacterium designed were spotted onto nylon membrane to make a microarray, followed by hybridization to PCR products of bacteria, which set up a microarray technique for parallel detection of bacteria in cerebrospinal fluid (CSF). Twenty-nine CSF specimens from 16 patients that were proved to be positive by bacterial cultures and by using Vitek AMA-32 automated system were examined in the present investigation. It was found that positive fragment with length of 168?bp were amplified from 45 strains of 20 bacterial species, and amplifications also detected in 29 CSF specimens. The method of universal PCR could detect as few as 1 pg of bacterial DNA, and this microarray could identify all the bacterial species in CSF except Mycobacterium tuberculosis and Proteus mirabilis , satisfying the direct detection of bacteria in CSF specimens including a case of mixed bacterial infection. The positive and negative predictive value as well as the diagnostic index of this microarray were 100%, 94.67%, and 180.88 respectively, and the time of performance spent only for 5?h. It was concluded the method described in the present investigation can be used to detect and identify the pathogenic bacteria in CSF.

Association of neuroelectrophysiology and analysis of cerebrospinal fluid immunoglobulin with pathogenetic conditions of patients with Guillain-Barre syndrome

BACKGROUND： Guillain-Barre syndrome （GBS） is an autoimmune disease which is characterized by demyelination of peripheral nerve and nerve root, and inflammatory reaction of lymphocyte and macrophage. Neuroelectrophysiological examination and cerebrospinal fluid （CSF） analysis are of significance for its diagnosis. OBJECTIVE： To study the association of neuroelectrophysiology and cerebrospinal fluid immunoglobulin （CSF-lg） with pathogenetic conditions of patients with GBS. DESIGN： Case control study SETTING： Department of Neurology, Shenzhen Municipal Shekou Group Hospital; Department of Neuroelectrophysiology, People＇s Hospital of Guangdong Province. PARTICIPANTS： A total of 32 GBS patients including 18 males and 14 females who aged from 17 to 72 years were selected as experimental group from the Department of Neurology, People＇s Hospital of Guang- dong Province from January 2004 to December 2005. All cases conformed with GBS diagnostic criteria established by Asbury in 1990 and they were divided into three types according to neurological criteria established by Chinese Neurology and Psychology Journal in 1993： mild, moderate and severe types. Another 30 patients with vascular headache were selected as control group from the same hospital including 14 males and 16 females who aged from 17 to 79 years. METHODS： ① Neuroelectrophysiological examination： Multiple-functional electromyography device provided by Nicolet Company, USA was used to measure nerve conduction velocity （NCV）, including motor nerve conduction velocity （MCV） and sensory nerve conduction velocity （SCV）; meanwhile, electromyologram （EMG）, somatosensory evoked potential （SEP） and electroencephalogram （EEG） were also measured. ② Detection of CSF-lg： Concentrations of IgG, IgA and IgM were measured with immunofixation electrophoresis. ③Follow-up： Among 32 GBS patients, 14 cases received follow-up after treatment and the longest fol- low-up time was 1 year after onset. Among them, 8 cases were reexaminined with neuroelectrophysiological and CSF examinations. MAIN OUTCOME MEASURES： Results of NCV, EMG, SEP and EEG; comparison of CSF-lg content; results of follow-up examinations. RESULTS： All 32 GBS cases and 30 patients with vascular headache were involved in the final analysis. ① Abnormal rate of neuroelectrophysiological test： 75% of NCV, 88% of F-wave, 53% of MCV, 25% of SEP, 47% of EMG and 31% of EEG. There were no significant differences among various types （P 〉 0.05）. ② Results of CSF-lg test： There were no significant differences among various types （P 〉 0.05）; however, abnormalities in experimental group was higher than those in control group （P 〈 0.01）. CONCLUSION ： Results of follow-up study suggest that improvement of clinical symptom is earlier than neuroelectrophysiological recovery; MCV and EMG recoveries are faster than that of NCV; the earlier the abnormality of EMG, the poorer the recovery. CSF4g recovers normally along improvement of clinical symptoms. It is of significance for neuroelectrophysiology and abnormality of CSF-Ig to determine degree of peripheral nerve demyelination and prognosis.

Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients

BACKGROUND Meningitis is a life-threatening clinical condition associated with high mortality and morbidity.Early diagnosis and specific treatment may improve outcomes.Lack of specific clinical signs or tests make the diagnosis challenging.AIM To assess the efficacy of cerebrospinal fluid(CSF)lactate in diagnosing meningitis in critically ill patients.METHODS A prospective,observational cohort study was carried out in a neuro-medical intensive care unit(ICU)over a 22 mo period.Adult patients,with suspected meningitis admitted in ICU,were serially recruited.Patients who refused consent,those with peripheral sensorineural deficit,or with any contraindication to lumber puncture were excluded.CSF cytology,bio-chemistry,lactates,culture and polymerase chain reaction based meningo-encephalitis panel were evaluated.Patients were divided in two groups based on clinical diagnosis of meningitis.The efficacy of CSF lactate in diagnosing meningitis was evaluated and compared with other tests.RESULTS Seventy-one patients were included and 23 were diagnosed with meningitis.The mean values of CSF total leucocyte count(TLC),proteins and lactates were significantly higher in meningitis group.There was a significant correlation of CSF lactate levels with CSF cultures and meningo-encephalitis panel.CSF lactate(>2.72 mmol/L)showed good accuracy in diagnosing meningitis with an area under the curve of 0.81(95% confidence interval:0.69-0.93),sensitivity of 82.6%,and specificity 72.9%.These values were comparable to those of CSF TLC and protein.Twelve patients with bacterial meningitis had significantly higher CSF lactate(8.9±4.7 mmol/L)than those with non-bacterial meningitis(4.2±3.8 mmol/L),P=0.006.CONCLUSION CSF lactate may be used to aid in our diagnosis of meningitis in ICU patients.CSF lactate(>2.72 mmol/L)showed good accuracy,sensitivity,and specificity in diagnosing meningitis and may also help to differentiate between bacterial and non-bacterial meningitis.

The causes and prevention and treatment of cerebrospinal fluid leak during transsphenoidal pituitary adenomas surgery

Objective To analyze the causes and prevention and treatment of cerebrospinal fluid leak during transsphenoidal pituitary adenoma surgery. Methods Retrospective study of 260 cases of microscopic transsphenoidal surgery and 274 cases of endoscopic surgery for resection of the pituitary adenomas was performed. CSF leak occurred

Cerebrospinal Fluid Leakage after Thoracic Decompression

Objective： The objective of this study is regular and special features. to review cerebrospinal fluid leakage （CSFL） after thoracic decompression and describe its Data Sources： Literature cited in this review was retrieved from PubMed and Medline and was primarily published during the last 10 years. ＂Cerebrospinal fluid＂, ＂leakage＂, ＂dural tears＂, and ＂thoracic decompression＂ were the indexed terms. Relevant citations in the retrieved articles were also screened to include more data. Study Selection： All retrieved literature was scrutinized, and tbur categories were recorded： incidence and risk factors, complications, treatment modalities, and prognosis. Results： CSFL is much more frequent after thoracic decompression than after cervical and lumbar spinal surgeries. Its occurrence is related to many clinical factors, especially the presence of ossified ligaments and the adhesion of the dural sac. While its impact on the late neurological recovery is currently controversial, CSFL increases the risk of other perioperative complications, such as low intracranial pressure symptoms, infection, and vascular events. The combined use of primary repairs during the operation and conservative treatment postoperatively is generally effective for most CSFL cases, whereas lumbar drains and reoperations should be implemented as rescue options for refractory cases only. Conclusions： CSFL after thoracic decompression has not been specifically investigated, so the present study provides a systematic and comprehensive review of the issue. CSFL is a multi-factor-related complication, and pathological fators play a decisive role. The importance of CSFL is in its impact on the increased risk of other complications during the postoperative period. Methods to prevent these complications are in need. In addition, though the required treatment resources are not special for CSFL after thoracic decompression, most CSFL cases are conservatively curable, and surgeons should be aware of it.

小儿中枢神经系统感染脑脊液时IL-8和G-CSF的检测价值

目的 :探讨小儿中枢神经系统感染时白介素 8(IL 8)、粒细胞集落刺激因子 (G CSF)的变化。方法 :用ELISA法检测 91例中枢神经系统感染患儿中的 5 9例病毒性脑炎或脑膜脑炎 (Vm&Ve)患儿、2 2例化脓性脑膜炎患儿 (Pm)和 10例结核性脑膜炎患儿 (Tm) ,并以 2 1例非神经系统疾病患儿的脑脊液、血清G CSF和IL 8活性作为对照。结果 :患儿组脑脊液IL 8明显高于对照组 (P <0 .0 5 ) ,但患儿组间差异无显著性。G CSF各组间差异无显著性。结论 :IL 8在中枢神经系统感染发病中起作用 ,但IL 8、G CSF的检测无鉴别诊断价值。

Kallikrein-related peptidases 6 and 10 are elevated in cerebrospinal fluid of patients with Alzheimer’s disease and associated with CSF-TAU and FDG-PET

Background:Alterations in the expression of human kallikrein-related peptidases(KLKs)have been described in patients with Alzheimer’s disease(AD).We elucidated the suitability of KLK6,KLK8 and KLK10 to distinguish AD from NC and explored associations with established AD biomarkers.Methods:KLK levels in cerebrospinal fluid(CSF),as determined by ELISA,were compared between 32 AD patients stratified to A/T/(N)system with evidence for amyloid pathology and of 23 normal controls with normal AD biomarkers.Associations between KLK levels and clinical severity,CSF and positron emission tomography(PET)based AD biomarkers were tested for.Results:Levels of KLK6 and KLK10 were significantly increased in AD.KLK6 differed significantly between AD A+/T+/N+and AD A+/T−/N+or NC with an AUC of 0.922.CSF pTau and tTau levels were significantly associated with KLK6 in AD.Conclusions:KLK6 deserves further investigations as a potential biomarker of Tau pathology in AD.

Subdural fluid collection rather than meningitis contributes to hydrocephalus after cervical laminoplasty:A case report

BACKGROUND Hydrocephalus following dural tear after spinal surgery is rare.Although a few cases of obstructive hydrocephalus caused by subdural fluid collection and communicating hydrocephalus associated with meningitis have been reported,the mechanism remains uncertain.Herein we describe a patient complicated with hydrocephalus after cervical laminoplasty in whom subdural fluid collection in the cervical spine and posterior cranial fossa rather than chronic meningitis was the main mechanism.CASE SUMMARY A 45-year-old man underwent cervical laminoplasty for cervical spondylotic myelopathy at a local hospital.Ten days postoperatively,a high fever occurred and magnetic resonance imaging(MRI)showed cerebrospinal fluid(CSF)leakage.Pseudomeningocele liquid test showed high levels of protein and white blood cell(WBC)count with negative bacterial culture.The patient was treated with shortterm intravenous antibiotic and discharged with normal body temperature.The patient was uneventful during the first 8 mo follow-up although repeated MRI showed persistent pseudomeningocele.At the 9th mo postoperatively,the patient gradually presented with dizziness and headache accompanied by recurrent weakness of his left arm.Imaging examinations demonstrated hydrocephalus and a cystic lesion around the cervical spinal cord.CSF test from lumbar puncture indicated chronic meningitis.MRI on 1 d after pseudomeningocele drainage showed a significant decrease in the cystic volume,suggesting that the cystic lesion would be subdural fluid collection rather than adhesive arachnoiditis.After dural defect repair,the patient’s symptoms completely resolved and hydrocephalus gradually disappeared.CSF analysis at the 21-mo follow-up revealed significantly decreased protein level and WBC count.CONCLUSION Subdural fluid collection rather than meningitis contributes to the hydrocephalus formation after cervical laminoplasty.

The embryonic blood–CSF barrier has molecular elements for specific glucose transport and for the general transport of molecules via transcellular routes

In vertebrates, early brain development takes place at the expanded anterior end of the neural tube, which is filled with embryonic cerebrospinal fluid (E-CSF). We have recently identified a transient blood–CSF barrier that forms between embryonic days E3 and E4 in chick embryos and that is responsible for the transport of proteins and control of E-CSF homeostasis, including osmolarity. Here we examined the presence of glucose transporter GLUT-1 as well the presence of caveolae-structural protein Caveolin1 (CAV-1) in the embryonic blood-CSF barrier which may be involved in the transport of glucose and of proteins, water and ions respectively across the neuroectoderm. In this paper we demonstrate the presence of GLUT-1 and CAV-1 in endothelial cells of blood vessels as well as in adjacent neuroectodermal cells, located in the embryonic blood–CSF barrier. In blood vessels, these proteins were detected as early as E4 in chick embryos and E12.7 in rat embryos, i.e. the point at which the embryonic blood–CSF barrier acquires this function. In the neuroectoderm of the embryonic blood-CSF barrier, GLUT-1 was also detected at E4 and E12.7 respectively, and CAV-1 was detected shortly thereafter in both experimental models. These experiments contribute to delineating the extent to which the blood–CSF embryonic barrier controls E-CSF composition and homeostasis during early stages of brain development in avians and mammals. Our results suggest the regulation of glucose transport to the E-CSF by means of GLUT-1 and also suggest a mechanism by which proteins are transported via transcellular routes across the neuroectoderm, thus reinforcing the crucial role of E-CSF in brain development.

硬性支撑联合带蒂鼻中隔黏膜瓣技术在垂体瘤术后鞍底重建中的应用

目的探讨硬性支撑联合带蒂鼻中隔黏膜瓣技术在垂体瘤术后鞍底重建中的应用。方法采用回顾性和观察性的研究方法收集2019年8月至2023年5月西安交通大学第一附属医院神经外科完成的54例经鼻蝶垂体瘤切除患者的临床资料,依据鞍底重建方式分为硬性支撑组和软性重建组,比较两组手术时间、脑脊液漏发生及住院时间等情况。结果两组手术时间及术中出血量比较,差异无统计学意义(P>0.05)。硬性支撑组的术后脑脊液漏发生率及腰大池置管率低于软性重建组,住院时间短于软性重建组(P<0.05)。结论硬性支撑联合带蒂鼻中隔黏膜瓣技术能有效减少经鼻蝶垂体瘤术后脑脊液漏的发生。

颅内曲霉菌病临床分析

目的探讨颅内曲霉菌病(intracranial aspergillosis,ICA)的临床和影像学特点及其预后。方法选取2013年1月至2024年1月首都医科大学附属北京友谊医院ICA患者9例,回顾性分析患者的临床表现、实验室检查结果、影像学特征、治疗方案和临床预后等。结果9例患者中,男5例、女4例;年龄4~70岁,平均40.4岁。ICA常见的临床表现有发热、头痛、脑神经受累、神经系统缺损症状和意识障碍等。6例患者行脑脊液检查,其中3例脑脊液压力及WBC均升高。头颅影像学示常见侵袭部位为脑实质、脑血管、海绵窦、脑膜和垂体。8例患者接受了伏立康唑药物治疗,平均治疗疗程6个月。截至2024年3月的随访,共有4例患者死亡。结论ICA常伴发脑血管疾病,尤其是脑膜型病变;ICA的临床表现缺乏特异性,免疫功能正常的人群也有曲霉菌感染的风险。mNGS有助于早期ICA的诊断,早期规范应用伏立康唑等抗真菌治疗,可明显改善患者预后。

颅底骨折患者脑脊液漏护理效果分析

分析颅底骨折脑脊液漏患者临床实施护理干预的效果。选取灵山县人民医院神经外科收治的80例颅底骨折脑脊液漏患者作为研究对象,随机将患者分为对照组和观察组。对照组行常规护理,观察组行护理干预,比较组间护理效果,以此探讨护理干预的有效性。结果显示,与对照组比较,观察组患者各项临床指标优于对照组,护理舒适度和护理满意度高于对照组(P<0.05)。研究发现,临床针对颅底骨折脑脊液漏患者开展针对性护理干预,可以明显缩短患者临床指标康复时间,提高患者的舒适度和满意度,可于临床推广。

新型加压绷带在腰椎术后脑脊液漏病人中的临床应用

目的探讨自行设计的新型加压绷带在腰椎术后脑脊液漏病人中的临床应用。方法选取2021年4月至2022年4月我科腰椎术后脑脊液漏病人42例,应用随机数字表法分为观察组和对照组,每组21例。观察组脑脊液漏病人使用自行设计的新型加压绷带加压包扎治疗,对照组使用普通腹带加压包扎治疗。观察两组病人加压包扎护理耗时、引流管留置时间和加压包扎处的皮肤情况。结果观察组加压包扎护理耗时和引流管留置时间均较对照组明显缩短[(1.12±0.24)分vs.(6.74±1.43)分;(5.09±1.12)d vs.(7.18±1.16)d],差异均有统计学意义(P<0.001)。观察组加压包扎处皮肤无异常;对照组发生皮肤异常9例(42.86%),其中红肿4例、水疱1例、破皮4例。结论新型加压绷带有助于提高加压包扎的护理效果,缩短加压包扎护理耗时和引流管留置的时间,明显改善病人加压包扎处的皮肤状况,极大地降低了护理不良事件的发生,促进了病人术后的康复。

神经内镜下经鼻蝶入路治疗Rathke’s囊肿

目的研究神经内镜技术治疗Rathke’s囊肿(Rathke’scleft cysts,RCC)的有效性。方法回顾性分析34例RCC病例资料,均采用神经内镜技术治疗,对比手术前后病人头疼、视力障碍、内分泌障碍等症状的改善,以及术后脑脊液漏的发生与囊肿复发情况等。结果33例采用内镜下囊肿开窗或囊壁部分切除术,1例囊壁全切除。术前有头疼症状21例(61.8%),术后1周~12个月头疼症状改善9例。术前视力下降9例(26.5%),术后改善2例。术前垂体功能异常21例(61.8%),术后恢复正常7例。1例囊壁全切除病人,术后持续性脑脊液漏,保守治疗1个月后行二次手术修补。复发2例(5.9%),1例随访未手术,1例2年后囊肿萎缩消失。无手术相关死亡。结论神经内镜技术可用于治疗出现头疼、视力下降、激素水平改变的RCC病人。

30例低颅压综合征临床特点分析

目的总结自发性或继发性低颅压综合征(intracranial hypotension syndrome,IHS)患者的临床特点。方法回顾性分析2022年9月至2023年5月我院诊断为自发性或继发性IHS的患者,收集临床资料,总结影像学特点、治疗方式以及预后。结果共入组30例,自发性和继发性IHS患者占比分别为63%(19例)和37%(11例)。临床特征上,直立性头痛最为常见(29例,96.7%),最常累及枕部(12例,40.0%),其次是额顶部(9例,30.0%);头颅影像学特征中,硬脑膜强化出现率最高(17例,56.7%)。CT脊髓造影显示,脑脊液漏最常见的位置是脊柱颈段(10例)和上胸段(9例),其次是下胸段(4例)和腰段(4例)。经保守治疗和靶向硬膜外血贴手术治疗,患者总有效率90%。结论直立性头痛和头颅MRI“硬脑膜强化”对于IHS的定性诊断有强提示作用,CT脊髓造影有助于脑脊液漏点的精确定位,靶向硬膜外血贴治疗是保守治疗无效时治愈IHS的有效方法。

肥胖与前庭神经鞘瘤患者术后并发症及二次手术的关联性研究

目的探讨肥胖与前庭神经鞘瘤(VS)患者术后并发症及二次手术的关联性。方法回顾性分析2013年6月至2023年6月于新疆医科大学第一附属医院接受乙状窦后入路手术治疗的377例VS患者的临床及影像学资料。根据体质量指数(BMI)将患者分为肥胖组(BMI≥28 kg/m^(2),91例)和非肥胖组(BMI<28 kg/m^(2),286例)。比较两组临床资料及术后并发症发生率和二次手术率,采用多因素logistic回归分析探讨BMI对术后脑脊液漏及二次手术的影响。结果与非肥胖组相比,肥胖组性别为男性,以及合并糖尿病、高血压的人数比例更大,差异有统计学意义(P<0.05)。两组年龄、住院时间、手术侧别、肿瘤性质、肿瘤体积分级、手术时间比较差异无统计学意义(P>0.05)。肥胖组术后脑脊液漏发生率及二次手术率高于非肥胖组,差异有统计学意义(P<0.05)。两组颅内出血、切口感染、颅内感染、深静脉血栓及其他术后并发症发生率比较差异无统计学意义(P>0.05)。经调整年龄、性别、肿瘤体积分级、肿瘤性质后,多因素logistic回归分析结果显示,较高的BMI水平是患者发生术后脑脊液漏[OR(95%CI)=1.168(1.051~1.299),P=0.004]及二次手术[OR(95%CI)=1.160(1.053~1.277),P=0.003]的危险因素。结论肥胖与VS患者术后脑脊液漏和二次手术密切相关,且BMI增高是VS患者术后脑脊液漏和二次手术的危险因素。

脑室腹腔分流术治疗犬脑积水的病例分析

为了探索犬脑积水(Hydrocephalus)的替代疗法并提高患犬生活质量,本文分析了1例临床50日龄患有脑积水的边境牧羊犬,初期尝试药物管理和最终采用手术治疗的方案。结果显示,采取药物保守治疗,目的为减少患犬脑脊液(CSF)的产生并增加其排出,但2周后临床症状无明显改善,遂进行脑室腹腔分流术治疗。术后患犬神经症状有所缓解,影像学检测结果显示CSF有所减少。术后约1个月,患犬因厌食、器官衰竭和手术引流失败而死亡。结果表明,在药物控制无效的情况下,脑室腹腔分流术可作为脑积水的替代治疗方法。虽然本病例患犬最终死亡,但为脑积水的诊断和治疗提供了参考。