Meng Liu, Yuguang Liu, Shugan Zhu, Xingang Li, Chengyuan Wu
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, People's Republic of China.
J Clin Neurosci. 2006 May;13(4):428-30. doi: 10.1016/j.jocn.2005.04.022. Epub 2006 Mar 27.
To study the clinical characteristics of intraventricular epidermoids, we analysed retrospectively 12 patients treated in our hospital and reviewed the literature with regard to clinical manifestations, imaging features, diagnosis, surgical procedures and prognosis. Four patients with lateral ventricle epidermoid and eight in the fourth ventricle were included in this group. Intraventricular epidermoids are characteristically hypodense non-enhancing lesions on CT scans. MRI reveals them to have long T1 and T2 relaxation times with slight mass effect. Total removal is ideal, but special attention should be paid to preservation of important neurovascular structures. Close proximity of tumours to cranial nerves and the brain stem pose technical difficulties in total removal. Cranial nerve dysfunction and aseptic meningitis are the main postoperative complications. Long-term prognosis for patients with intraventricular epidermoids and well-preserved neurological conditions is good, even in the case of subtotal excision. Clinical follow-up and MRI allow earlier diagnosis of recurrence.
为研究脑室内表皮样囊肿的临床特征,我们回顾性分析了我院收治的12例患者,并就临床表现、影像学特征、诊断、手术方法及预后等方面复习了相关文献。该组包括4例侧脑室表皮样囊肿患者和8例第四脑室表皮样囊肿患者。脑室内表皮样囊肿在CT扫描上典型表现为低密度无强化病灶。MRI显示其具有长T1和T2弛豫时间,并有轻微占位效应。理想的治疗是完全切除,但应特别注意保留重要的神经血管结构。肿瘤与颅神经和脑干紧邻会给完全切除带来技术困难。颅神经功能障碍和无菌性脑膜炎是主要的术后并发症。即使是次全切除,脑室内表皮样囊肿且神经功能良好的患者长期预后也较好。临床随访和MRI有助于早期诊断复发。