枕大池蛛网膜囊肿的诊断与治疗

目的：探讨枕大池蛛网膜囊肿的正确诊断与显微手术治疗。方法：对１０例枕大池蛛网膜囊肿的临床表现、ＣＴ和ＭＲＩ检查及术中所见进行分析。结果：１０例经手术和病理检查证实为枕大池蛛网膜囊肿,无１例手术死亡。术后临床症状消失或明显好转,ＣＴ或ＭＲＩ复查囊肿明显缩小。结论：枕大池蛛网膜囊肿的正确诊断依赖于临床表现、ＣＴ或ＭＲＩ检查,注意与巨型枕大池的鉴别诊断,显微手术切除效果较好。     

囊肿-腹腔分流术治疗侧裂池蛛网膜囊肿

我科2001年1月～2003年4月对8例颅中窝蛛网膜囊肿病人行囊肿-腹腔分流术,疗效较好,现报道如下:1对象与方法1.1一般资料男5例,女3例;年龄3岁4个月～15岁7例,1例29岁。临床表现为头痛3例,头痛伴呕吐2例,局部颅骨隆起1例,抽搐2例,视神经萎缩1例。囊肿3.7cm×2.7cm～8.4cm×4.1cm。均行CT或MR扫描。1.2手术方法选择中、低压分流管。行病侧颞部直切口,长3～4cm,撑开切口,止血,颅骨钻孔,电灼硬膜后“十”字切开,穿刺有脑脊液喷出,说明压力较高,将脑室腹腔分流管的脑室端插入囊腔内,深度根据囊肿腔的大小而定,一般2～4cm。其余手术操作同腹腔分流…     

囊肿-腹腔分流术治疗老年人枕大池蛛网膜囊肿

<正>自2003年1月至2012年12月,共收治老年人枕大池蛛网膜囊肿49例,其中16例有颅内压增高症状,均采取囊肿-腹腔分流手术治疗,效果明显,现报道如下。1临床资料1.1一般资料本组患者16例均符合枕大池蛛网膜囊肿诊断,其中男11例,女5例;年龄60~78岁,平均69.2岁。病史2~23年,平均24年。头痛头晕9例,头痛伴恶心呕吐2例,存     

颅内蛛网膜囊肿的诊疗策略

目的探讨颅内蛛网膜囊肿（IAC）的治疗策略。方法对48例CT诊断IAC病人结合临床表现、CT平扫以及CT蛛网膜下腔一脑池造影（CTC）来判断手术指征。结果26例行手术治疗,22例行保守治疗。行手术治疗的26例患者中,失访2例,24例术后症状改善或消失。未行手术治疗的22例患者中,失访6例,症状改善6例,症状仍间断发作,药物可控制但效果不佳10例。结论具有明显手术指征的患者行手术治疗;手术指征不明显,能够接受CTC检查且结果为非交通性蛛网膜囊肿（NCIAC）的患者行手术治疗;交通性蛛网膜囊肿（CIAC）、手术指征不明显不愿接受CTC检查、不能接受手术治疗的患者行保守治疗,随访观察。     

儿童颅内蛛网膜囊肿大部分切除-脑池交通术

我院自1991年1月-2000年10月共收台颅内蛛网膜囊肿（intracranial arachnoid cyst,IAC）患21例，均施行手术治疗，其中6例颅中窝侧裂池蛛网膜囊肿实施囊壁大部分切除-脑池交通术，效果良好。     

显微手术治疗颅内蛛网膜囊肿

颅内蛛网膜囊肿 (ｉｎｔｒａｃｒａｎｉａｌａｒａｃｈｎｏｉｄｃｙｓｔ,ＩＡＣ)是非肿瘤良性病变 ,约占颅内占位性病变的 0 .4 %～ 1.0 % [1] 。一般认为有症状的ＩＡＣ需手术治疗 ,手术方法较多 ,但并非全部有效 ,部分患者仍有复发。我科从 1998至 2 0 0 1年间收治有症状的ＩＡＣ患者 5 9例。其中 34例行常规开颅 ,ＩＡＣ囊壁肉眼大部分切除术 ,效果不甚理想 ,复发率较高 ,其余 2 5例行显微手术治疗 ,取得了较为满意的结果 ,现报告如下一、对象与方法1.临床资料 :本组男 18例 ,女 7例 ,年龄 15～ 4 8岁 ,平均31.5岁。病程 4周～ 5年不等。…     

CT脑池造影在颅内蛛网膜囊肿诊断及治疗中的应用

目的 探讨CT脑池造影(CTC)在颅内蛛网膜囊肿(IAC)诊断及治疗中的应用价值.方法 南方医科大学南方医院神经外科自2006年10月至2009年10月共收治23例IAC患者.其中非交通性蛛网膜囊肿(NCtAC)患者采用神经内镜造瘘并部分囊壁切除手术治疗,交通性蛛网膜囊肿(CIAC)患者采用保守治疗,通过患者手术前后CT、MRI及CT脑池造影(CTC)检查,分析CTC在鉴别诊断CIAC和NCIAC、评价手术治疗NCIAC的效果中的作用. 结果 CTC证实本组患者中17例为NCIAC即真性囊肿,6例为CIAC即假性囊肿;随访术后NCIAC患者CT或MRI检查显示1例囊肿消失,13例囊肿有不同程度缩小,3例无明显变化.随机抽取8例NCIAC患者行CTC检查显示囊肿与脑池沟通良好. 结论 CTC对颅内囊性病变的诊断,尤其是对CIAC和NCIAC的鉴别诊断中的作用尤为重要,CTC检查为颅内囊性病变是否手术治疗提供明确指征,并且术后CTC检查可初步评价囊肿手术效果.     

脊髓蛛网膜囊肿的显微手术治疗

一、临床资料本组共 2 8例 ,男 17例 ,女 11例。年龄 7～ 5 8岁 ,平均 32 4岁。术前病程 6个月至 12年 ,平均 2 1 6月。囊肿部位颈段 3个 ,胸腰段 19个 ,骶部马尾 6个。临床表现肌力障碍 2 8例 ,深感觉障碍 13例 ,浅感觉障碍18例 ,二便障碍 10例 ,自发疼痛 15例。有明显感染史者 2例 ,有外伤史者 4例 ,不明原因者 2 2例。本组 2 8例全部做ＭＲＩ检查 ,其中 3例呈蛛网膜囊肿样改变 ,有占位效应。其余 2 5例表现脊髓明显增粗 ,呈均匀低信号 ,常伴有多个囊腔。Ｔ2显示异常高信号 ,难以区分界限。强化扫描囊肿壁显示局限性强化。二、结果2 8例…     

Endoscopic ventriculo-cystomy for non-communicating hydrocephalus secondary to quadrigeminal cistern arachnoid cyst

INTRODUCTION: Intracranial arachnoid cysts are developmental, anomalous collections of cerebrospinal fluid (CSF), and occasionally cause symptoms when large enough to obliterate the CSF outflow pathway and give rise to non-communicating hydrocephalus. The treatment of choice for symptomatic arachnoid cysts has been surgical excision or fenestration of the cyst, but less invasive endoscopic fenestration has been attempted with favorable preliminary results. CASE REPORT: We report a case of non-communicating hydrocephalus caused by a quadrigeminal cistern arachnoid cyst in a 35-year-old woman who presented with worsening headaches. She was successfully treated by endoscopic third ventriculostomy and fenestration of the cyst (ventriculo-cistomy). DISCUSSION: Endoscopic fenestration of symptomatic arachnoid cysts can be as effective as open surgery in terms of short-term efficacy, and it is certainly less invasive than open surgery. However, its long-term outcome remains unknown, and these rare cases require careful clinical and radiological follow-up.     

Prenatal diagnosed cyst of the quadrigeminal cistern in Aicardi syndrome

Aicardi syndrome is an X-linked dominant disorder characterized by the pathognonomic association of three clinical signs: agenesis of the corpus callosum, infantile spasms, and chorioretinal lacunae. This is a severe syndrome with an estimated survival rate of 76% at 6 years and 40% at 14 years and a maximum developmental level like a 12-month-old baby in 91% of cases. We illustrate a case of Aicardi syndrome with bilateral, small chorioretinal lacunae, infantile spasms with a typical hypsarrhythmia, defects of thoracic vertebra and bilateral absence of the12th rib associated with an arachnoid cyst of the quadrigeminal cistern, and presence of the corpus callosum with a favorable outcome.     

Postinflammatory arachnoid cyst of the quadrigeminal cistern

Arachnoid cysts of the quadrigeminal cistern are rare. Patients with this lesion are usually normal at birth, and signs of increased intracranial pressure (IICP) develop at about 4 to 12 months of age. However, there has been no report about this mechanism. A case of arachnoid cyst of the quadrigeminal cistern is presented. In this case, the process of the cyst growth was observed during the course of follow-up for shunted hydrocephalus. Symptoms coincided with the growth of the cyst. Therefore, the development of the clinical symptoms was thought to be due to IICP caused by cyst expansion. Our case was complicated by inflammation, something that may offer a key to solving the mechanism of cyst fluid accumulation and the relationship between symptoms and development of the cyst.     

Arachnoid cyst of the collicular cistern

Arachnoid cysts of the collicular cistern are rare. Two patients with this lesion are reported in whom the extent and location of the cyst were shown by computed tomography. The clinical and radiographic features of this lesion are summarized.     

Fetal arachnoid cyst of the quadrigeminal cistern in MRI and ultrasound

Case The authors report a fetus with an arachnoid cyst of the quadrigeminal cistern without hydrocephalus at 30 gestational weeks.Discussion and conclusion We reviewed the literature and could find only 62 reported cases of arachnoid cyst of the quadrigeminal cistern. We present a case without hydrocephalus diagnosed by combining ultrasound (US) and magnetic resonance imaging (MRI). The fetus, born by normal delivery, was followed up and did not show hydrocephalus for 1 year. This combined prenatal study, which uses US and MRI, helps in dispensing proper counseling to parents and assists the gynecologist and the neurosurgeon in the pre- and postnatal management of this condition.     

蛛网膜下腔顺向交通术治疗颅内蛛网膜囊肿

目的探讨颅内蛛网膜囊肿(intracranial arachnoid cyst,IAC)的有效治疗方法。方法采用蛛网膜下腔顺向交通术治疗IAC29例,并进行分析。结果28例患者术后临床症状消失或缓解,术后3~12月复查CT或MRI,囊肿消失或明显缩小;1例枕大池蛛网膜囊肿,术后1.5年囊肿未见缩小,临床症状无明显改善,改行囊肿-腹腔分流术,治愈。结论蛛网膜下腔顺向交通术是目前治疗IAC的有效方法,手术应采用显微神经外科技术。     

Lipoma of the quadrigeminal plate cistern

Two cases of quadrigeminal plate cistern lipoma detected by CT scan, one of which produced impairment of vertical gaze, are reported. The problems of diagnosis and therapy of intracranial lipomas are briefly discussed.

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Sommario Gli Autori riportano due pazienti affetti da lipoma della cisterna della lamina quadrigemina diagnosticati con la tomografia computerizzata. Uno di questi presentava una limitazione dello sguardo verso l'alto.Vengono brevemente discussi i problemi concernenti la diagnosi e la terapia dei lipomi intracranici.

     

脚间池的显微外科解剖及其临床意义

目的为脚间池及其周围病变的显微外科手术提供线索。方法在手术显微镜(10×)下对脚间池进行解剖和观察。结果脚间池蛛网膜和小梁丰富,池壁由Liliequist膜中脑叶、间脑叶和中间叶、中脑脑桥内侧蛛网膜、中脑脑桥外侧蛛网膜构成,池内有基底动脉分叉蛛网膜、后穿蛛网膜。结论①脚间池是颅内蛛网膜和小梁结构最丰富的区域之一;②术中对到达脚间池途中的蛛网膜和小梁均应进行锐性分离;③开放脚间池有助于预防和治疗脑积水。     

蛛网膜囊肿55例外科治疗临床分析

目的 探讨蛛网膜囊肿的手术指征和手术方法.方法 回顾性分析收治的55例蛛网膜囊肿患者,其中行囊肿切除术12例,囊肿大部分切除 蛛网膜下腔疏通术27例,囊肿部分切除 脑池分流术4例,囊肿-腹腔分流术9例,3例未行手术治疗.结果 术后症状均有不同程度好转,3例未手术者因囊肿为非"责任"病灶而采取针对性治疗好转.结论 蛛网膜囊肿在明确"责任"病灶的前提下应积极手术治疗,囊肿-腹腔分流术可作为首选的治疗方法.