Abstract：
OBJECTIVE:Cranial nerve palsy (CNP) secondary to cerebrospinal fluid (CSF) diversion is less familiar to us as a result of its rarity in incidence and insidiousness in presentation. This study aims to further expound the pathophysiological mechanism, clinical presentation, diagnosis, management and prognosis of CNP. METHODS:From June 2012 to February 2015, 5 of 347 consecutive patients with CNPs secondary to different CSF diversion procedures were treated at our institution. A systematic PubMed search of published studies written in English for patients developing CNPs after CSF diversion procedures from January 1950 to June 2015 was conducted. RESULTS:Overall, 29 studies and 5 patients of the current series totaling 53 CNPs met the inclusion criteria. CN II, III, IV, V, VI, VII and VIII were got involved in 2 (3.8%), 2 (3.8%), 5 (9.4%), 1 (1.9%), 44 (83.0%), 4 (7.5%) and 1 (1.9%) patients respectively. Thirty-eight patients (71.7%) developed CNPs following inadvertent lumbar puncture, 8 (15.1%) following lumbar drainage, and 7 (13.2%) following ventriculoperitoneal shunt. Forty-eight (90.6%) patients got resolved completely. CONCLUSIONS:The proposed mechanism of CNP after CSF diversion procedure is CSF hypovolemia and subsequent downward displacement of the brain and traction and distortion of the vascular and peripheral neural structures. As a result of its distinct anatomic characteristics rather than long intracranial course, CN VI is most commonly affected. With early recognition and timely conservative management, most patients could get favorable recovery.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Li G,Zhu X,Zhang Y,Zhao J,Han Z,Hou Kdoi
10.1016/j.clineuro.2016.02.010subject
Has Abstractpub_date
2016-04-01 00:00:00pages
19-26eissn
0303-8467issn
1872-6968pii
S0303-8467(16)30050-6journal_volume
143pub_type
杂志文章,评审abstract：:Under an operative view, an aneurysm of the vertebral artery is located behind the lower cranial nerves. To prevent neurological deficits we employed electrophysiological monitoring while clipping an aneurysm of the vertebral artery. A 64-year-old woman had suffered a sudden severe headache in the morning. Computed to...
journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
doi：10.1016/s0303-8467(97)00086-3
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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doi：10.1016/j.clineuro.2008.03.010
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章,评审
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
doi：10.1016/0303-8467(96)00013-3
更新日期：1996-05-01 00:00:00
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
doi：10.1016/j.clineuro.2012.10.027
更新日期：2013-07-01 00:00:00
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
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journal_title：Clinical neurology and neurosurgery
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doi：10.1016/s0303-8467(98)00010-9
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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doi：10.1016/j.clineuro.2003.12.004
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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更新日期：2011-12-01 00:00:00
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
doi：10.1016/j.clineuro.2012.09.006
更新日期：2013-07-01 00:00:00
