Treatment of Fourth Ventricle Arachnoid Cyst via Anterior Hone of Lateral Ventricle Using Flexible Endoscope
柔性内镜下经侧脑室前角的四脑室蛛网膜囊肿手术治疗
论文英文摘要:
Background:Arachnoid cysts are common anomalies in the intracranial region. However, an intraventricular arachnoid cyst is rare, and occurrence within the fourth ventricle is especially uncommon; only 16 cases have been described in the literature. Arachnoid cysts in the fourth ventricle may cause obstructive hydrocephalus or cerebellar ataxia or cranial nerve palsy. Treatment of a fourth ventricular arachnoid cyst is complete or partial resection via a midline suboccipital approach. Recently, endoscopic fenestration has become the procedure of choice in the treatment of arachnoid cysts in supratentorial locations, but as yet there has been no report of treating a fourth ventricle arachnoid cyst using a flexible endoscope.
Case Description:We present the case of a 43-year-old man who suffered a recurrence of an arachnoid cyst in the fourth ventricle that had been partially excised 8 years previously using midline suboccipital craniectomy. Because of concerns of adhesions following the previous craniectomy, we decided to perform endoscopic treatment via the anterior horn of the lateral ventricle.
Conclusions:As per our knowledge, this is the first case reporting the treatment of an arachnoid cyst of the fourth ventricle using a flexible endoscope via the anterior horn of the lateral ventricle. This method can be used to treat arachnoid cysts of the fourth ventricle.
中文摘要:
背景:蛛网膜囊肿是颅内常见的病变。然而,脑室内的蛛网膜囊肿是少见的,生长在四脑室少见;文献中仅仅描述了16例。四脑室蛛网膜囊肿可引起梗阻性脑积水或小脑共济失调或颅神经麻痹。经正中枕下入路的完全或部分切除是四脑室蛛网膜囊肿的标准治疗方法。较近,内窥镜下开窗术成为幕上蛛网膜囊肿治疗的优选治疗方案,但是到今天没有使用柔性内窥镜治疗四脑室蛛网膜囊肿的报告。
患者描述:患者男,43岁,患有四脑室蛛网膜囊肿复发,8年前以经枕下正中入路部分切除。因为担心颅骨切除术后粘连的问题,我们决定实施经侧脑室前角的内窥镜下治疗。
结论:据我们所知,本报告是一例描述内窥镜下经侧脑室前角入路治疗四脑室蛛网膜囊肿治疗。该方法可用于治疗四脑室蛛网膜囊肿。
作为德国乃至国际神经内镜专家,Henry W.S. Schroeder(施罗德)教授拥有擅长领域涵盖内镜神经外科(脑积水、囊肿、脑室内病变)、内镜颅底手术(脑膜瘤、前庭神经鞘瘤、表皮样囊肿)、鼻内镜颅底手术(垂体瘤、颅咽管瘤)、周围神经手术等,经其神经内镜手术治疗的脑膜瘤、垂体瘤、颅咽管瘤病例切除率高、治愈率高、复发率较低。
此外,Henry W.S. Schroeder(施罗德)教授对于国际神经外科学术研究及发展贡献卓著,他曾在各类神经外科杂志、期刊上发表了上百余篇学术论文,且与德国其他神经外科专家一起合著、编纂了《神经内镜手术》和《神经外科实用手册》等丛书,对于神经外科医生具有较大的临床实践指导意义。以其超群的神经内镜技术和深厚的学术功底,Henry W.S. Schroeder教授经常作为特邀讲师来华指导国内神经外科专家进行垂体瘤、脑膜瘤、颅咽管瘤等神经内镜手术技术培训,并多次受邀参与范围内研讨神经外科肿瘤疾病诊治的学术盛会。