Baykaner M K, Doğulu F, Oztürk G, Edali N, Tali T
Department of Neurosurgery, Gazi University, Ankara, Turkey.
J Neurosurg. 2000 Jul;93(1 Suppl):142-4. doi: 10.3171/spi.2000.93.1.0142.
Spinal hydatid disease is a rare entity that frequently yields to severe, acute-onset neurological deficits. Although the gold standard treatment is total surgical removal of the cysts without inducing any spillage, it may not be possible to perform this in patients with multiple and fragile cysts. In such cases, the neural structures should be adequately decompressed and albendazole should be administered promptly. The authors describe the case of a 13-year-old girl who was admitted with a history of back pain and acute-onset lower-extremity weakness. Magnetic resonance imaging scans demonstrated severe spinal cord compression caused by multiple cysts involving T-4 and the mediastinum. The patient underwent surgery, and the cysts were removed, except for one cyst that was hardly exposed. Following histopathological confirmation of spinal hydatid disease, she was treated with albendazole for 1 year. One year postoperatively, the residual cyst had gradually shrunk and had almost disappeared. Although a single case is not sufficiently promising, we believe that administration of albendazole is efficient to prevent recurrences in cases in which it is not possible to obtain total removal of the cysts without inducing spillage.
脊柱包虫病是一种罕见疾病,常导致严重的急性神经功能缺损。尽管金标准治疗方法是完整手术切除囊肿且不发生任何囊液外溢,但对于患有多个易碎囊肿的患者,可能无法进行这种手术。在这种情况下,应充分减压神经结构并立即给予阿苯达唑治疗。作者描述了一名13岁女孩的病例,该女孩因背痛和急性下肢无力病史入院。磁共振成像扫描显示多个囊肿累及T-4和纵隔,导致严重脊髓受压。患者接受了手术,除一个几乎未暴露的囊肿外,其余囊肿均被切除。经组织病理学确诊为脊柱包虫病后,她接受了1年的阿苯达唑治疗。术后1年,残留囊肿逐渐缩小,几乎消失。尽管单个病例的效果并不十分理想,但我们认为,在无法完整切除囊肿且不发生囊液外溢的情况下,给予阿苯达唑可有效预防复发。