Nishimoto Hideaki, Wada Tsukasa, Kuroda Kiyoshi, Yoshida Yuki, Okuguchi Taku, Ogasawara Kuniaki, Ogawa Akira, Hiraga Megumi, Takahashi Akira
Department of Neurosurgery, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate 020-8505, Japan.
No Shinkei Geka. 2003 Mar;31(3):297-301.
We report a case of the development of cavum septi pellucidi and cavum Vergae after head trauma in a 29-year-old female patient. After the accident, cavum septi pellucidi and cavum Vergae gradually expanded. Using magnetic resonance imaging, we followed up the patient for 33 months after the head trauma. Preoperatively, metrizamide CT cisternography was performed in order to investigate CSF flow between the cavum septi pellucidi/cavum Vergae and the subarachnoid space. Using neuroendoscopy, we succeeded in opening the wall of the cavum septi pellucidi via anterior horn of the right lateral ventricle. Cystography was performed during the operation. The volume of the cavum septi pellucidi/cavum Vergae decreased remarkably. In this case, our CSF flow studies revealed that CSF flowed into the posterior part of the cavum Vergae from the third ventricle and did not flow backward to the third ventricle. Therefore, we considered that the development of cavum septi pellucidi/cavum Vergae was related to a one-way valve mechanism between the posterior part of the cavum Vergae and the third ventricle.
我们报告一例29岁女性患者头部外伤后透明隔腔和韦尔加腔形成的病例。事故发生后,透明隔腔和韦尔加腔逐渐扩大。我们利用磁共振成像对该患者头部外伤后进行了33个月的随访。术前,进行了甲泛葡胺CT脑池造影,以研究透明隔腔/韦尔加腔与蛛网膜下腔之间的脑脊液流动情况。我们通过神经内镜成功地经右侧侧脑室前角打开了透明隔腔壁。术中进行了囊腔造影。透明隔腔/韦尔加腔的体积显著减小。在本病例中,我们的脑脊液流动研究显示,脑脊液从第三脑室流入韦尔加腔后部,且未逆向流回第三脑室。因此,我们认为透明隔腔/韦尔加腔的形成与韦尔加腔后部和第三脑室之间的单向瓣膜机制有关。