Murakami Mamoru, Okumura Hirotaka, Kakita Kiyohito
Department of Neurosurgery, Kyoto First Red Cross Hospital, Kyoto, Japan.
Neurol Med Chir (Tokyo). 2003 Jun;43(6):312-5. doi: 10.2176/nmc.43.312.
A 48-year-old man presented with complaints of decreased visual acuity persisting for 6 weeks in December 1997. Neurological examination demonstrated defects in the superior bitemporal visual field and bilateral optic atrophy. Computed tomography and magnetic resonance (MR) imaging showed an intrasellar cystic lesion. The cyst wall was excised via a transsphenoidal approach. The diagnosis was intrasellar arachnoid cyst. The sellar floor was reconstructed after packing fat in the sellar turcica. The visual complaint improved, but he was lost to follow up. Four years later, he was re-admitted complaining of decreased visual acuity. Superior bilateral field defects were found. MR imaging revealed recurrence of the intrasellar arachnoid cyst. The cyst wall was excised through a craniotomy. The visual acuity and the visual field defects gradually improved. Intrasellar arachnoid cyst may recur after transsphenoidal surgery, so long-term follow up is necessary after excision of the intrasellar cyst wall.
一名48岁男性于1997年12月就诊，主诉视力下降持续6周。神经系统检查显示双侧颞上象限视野缺损及双侧视神经萎缩。计算机断层扫描和磁共振成像显示鞍内囊性病变。经蝶窦入路切除囊肿壁。诊断为鞍内蛛网膜囊肿。在蝶鞍内填充脂肪后重建鞍底。视力问题有所改善，但患者失访。4年后，他因视力下降再次入院。发现双侧上象限视野缺损。磁共振成像显示鞍内蛛网膜囊肿复发。通过开颅手术切除囊肿壁。视力和视野缺损逐渐改善。鞍内蛛网膜囊肿经蝶窦手术后可能复发，因此切除鞍内囊肿壁后需要长期随访。
