摘要
目的探讨脊髓终室囊样扩张的诊断及治疗经验。方法回顾性分析8例终室囊样扩张患者的临床资料及影像学资料。根据de Moura等建立的临床分类方法，本组2例为I型，4例为Ⅱ型，2例为Ⅲ型。6例Ⅱ型和Ⅲ型患者行后正中入路椎板切开术。术中后正中切开圆锥，囊腔内放置T型硅胶管，间断缝合软脊膜并固定T管，保持囊腔与蛛网膜下腔的通畅。结果术后5例患者症状明显改善，1例患者改善不明显，2例保守治疗的患者神经功能状态稳定。结论终室囊样扩张是一种少见的先天性疾病，MRI是首选的检查手段，囊腔-蛛网膜下腔分流术是有效的治疗方法。
Objective To study the diagnosis and treatment of cystic dilation of ventriculus terminalis （CDVT）. Methods The clinical manifestations and MRI characteristics of 8 cases of CDVT treated from Jan. 2006 to May. 2013 were analyzed. Results There were 6 female and 2 male patients. The mean age of patient was 47. 1 years old. The main symptoms were leg pain and spine cord compression. These lesions were spindle shaped, smooth walled, and without internal septae. The cystic contents had the same signal as cerebrospinal fluid on T1 and T2 MRI images, and without contrast enhancement. Two patients with Type I （ nonspecific complaints） symptoms were treated conservatively. The surgical treatment consisted of dorsolumbar laminotomy, myelotomy, and cyst - subarachnoid shunt placement. In patients with Type II （focal neurological deficits ） and III（ sphincter disturbances ） symptoms, surgical treatment sustained improvement. Conclusions CDVT is a rare congenital lesion. MRI is the first choice of diagnosis technique. Adequate decompression and cyst- subarachnoid shunt placement are the optimal treatment. Treatment for Type I lesion seems to be best conducted conservatively, whereas Types II and III seem to be best handled surgically.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第3期271-274,共4页
Chinese Journal of Neurosurgery
关键词
终室囊样扩张
囊腔-蛛网膜下腔分流术
显微手术
Cystic dilation of the ventriculus terminalis
Cyst - subarachnoid shunt
Microsurgery
