Nomura Sadahiro, Akimura Tatsuo, Imoto Hirochika, Nishizaki Takafumi, Suzuki Michiyasu
Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan.
Neurol Med Chir (Tokyo). 2002 Oct;42(10):452-4. doi: 10.2176/nmc.42.452.
A 32-year-old man presented with an arachnoid cyst of the posterior fossa manifesting as cervical syringomyelic myelopathy. Magnetic resonance (MR) imaging demonstrated edematous enlargement and T2 prolongation of the cervical spinal cord, indicating a "presyrinx" state. MR imaging showed the inferior wall of the cyst, which disturbed cerebrospinal fluid (CSF) pulsatile movement between the intraspinal and intracranial subarachnoid spaces. The cyst wall was fenestrated with a neuroendoscope. The presyrinx state and the CSF movement improved. Posterior fossa arachnoid cyst, as well as Chiari malformation, can cause CSF flow disturbance at the craniocervical junction and syringomyelia. Endoscopic fenestration is less invasive than foramen magnum decompression and should be the procedure of choice.
一名32岁男性因后颅窝蛛网膜囊肿就诊，表现为颈段脊髓空洞症。磁共振成像（MR）显示颈段脊髓水肿性增大和T2加权像信号延长，提示“脊髓空洞前期”状态。MR成像显示囊肿下壁，其干扰了脊髓内与颅内蛛网膜下腔之间的脑脊液（CSF）搏动性流动。用神经内镜对囊肿壁进行开窗。脊髓空洞前期状态和脑脊液流动情况得到改善。后颅窝蛛网膜囊肿以及Chiari畸形可导致颅颈交界处脑脊液流动障碍和脊髓空洞症。内镜下开窗术比枕骨大孔减压术侵入性小，应作为首选治疗方法。
