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[小脑桥脑角池囊尾蚴病。1例手术治疗病例及文献复习]

[Cisternal cysticercosis of the cerebellopontine angle. A surgically-treated case and review of the literature].

作者信息

Celis M A, Mourier K L, Polivka M, Boissonnet H, Kato T, Lot G, George B, Cophignon J

机构信息

Service de Neurochirurgie, Hôpital Lariboisière, Paris.

出版信息

Neurochirurgie. 1992;38(2):108-12.

PMID:1603232
Abstract

Most neurocysticercosis (N.C.C.) cases reported occur in undeveloped countries where contaminated food by Taenia solium gives rise to human infection. People of developed countries are exposed by migrations and travels. We report a case of a 36 years old french woman living at La Reunion. Her symptomatology consisted of left unilateral hypoacusis progressing over a two years period accompagnied by intermittent headaches. CT scan showed a hypodense mass with a ring enhancement in the left cerebello pontine angle (C.P.A.). M.R.I. showed multicystic arrangement of vesicles in a racemous fashion that spread out to peduncular and carotid cisterns. Parenchymatous or ventricular involvement was not observed. A lateral suboccipital craniectomy was carried up in the sitting position. After division of a thickened arachnoid in the C.P.A., the vesicles were dissected an pulled out easily because the membranes had not any adhesions. Progressive improvement of hearing was observed in the next week. Primary cisternal involvement of N.C.C. is rare and, in literature, there is not any other reported case in the C.P.A. Different mechanisms of invasion to the C.N.S. are discussed.

摘要

大多数报告的神经囊尾蚴病(N.C.C.)病例发生在不发达国家,那里受猪带绦虫污染的食物导致人类感染。发达国家的人则因移民和旅行而接触到该病。我们报告一例36岁生活在留尼汪岛的法国女性病例。她的症状包括两年间逐渐加重的左侧单侧听力减退,并伴有间歇性头痛。CT扫描显示左侧桥小脑角(C.P.A.)有一个低密度肿块,呈环状强化。磁共振成像(M.R.I.)显示囊泡呈多房性排列,呈葡萄状,延伸至脑桥和颈动脉池。未观察到实质或脑室受累。在坐位下行枕下外侧颅骨切除术。在分离桥小脑角增厚的蛛网膜后,囊泡很容易被分离并取出,因为其包膜没有粘连。术后一周听力逐渐改善。神经囊尾蚴病原发性脑池受累很少见,在文献中,桥小脑角区未报告过其他病例。本文讨论了囊尾蚴侵入中枢神经系统的不同机制。

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