Miyazaki Syndrome due to Ventriculoperitoneal Shunt Treatment

World Neurosurgery
Anita KovácsErika Vörös

Abstract

The signs and pathomechanism of Miyazaki syndrome is presented through the case of a young female patient. The 33-year-old patient had undergone placement of a ventriculoperitoneal shunt with a pressure-adjustable valve for communicating hydrocephalus years before presenting to our department with the complaints of constant headache and unsteady gait. On the basis of the clinical picture and her history, plain and contrast-enhanced cranial and whole spine magnetic resonance imaging and magnetic resonance angiography examinations were performed, with the scans revealing signs indicative of cerebrospinal fluid hypotension typical of Miyazaki syndrome. The article discusses the available literature suggesting the underlying cause in such cases to be the dysfunction of the Starling resistor mechanism due to an improperly adjusted ventriculoperitoneal shunt, which results in excessive cerebrospinal fluid loss accompanied by consequent cerebral venous overflow with vertebral venous engorgement and compressive cervical myelopathy.

References

Jan 20, 2007·Journal of Neurosurgery. Spine·William E HumphriesTimothy M George
Mar 25, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Juan F Martínez-LageJosé Hernández-Abenza
Jul 30, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Brian M HowardSanjay S Dhall
Apr 29, 2015·World Neurosurgery·Riccardo CarusoEmanuele Piccione
Jan 16, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Kaveh Barami, Sandeep Sood
Sep 2, 2016·Neurosurgical Focus·Jason Man-Kit HoKwong-Yui Yam

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Citations

Dec 2, 2020·World Neurosurgery·Tomonori IchikawaHidenori Suzuki

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