Zieliński Grzegorz, Podgórski Jan Krzysztof, Koziarski Andrzej, Potakiewicz Ziemowit
Klinika Neurochirurgii, Wojskowy Instytut Medyczny, ul. Szaserów 128, 00-909 Warszawa.
Neurol Neurochir Pol. 2006 Jul-Aug;40(4):347-52; discussion 353.
Intrasellar arachnoid cyst (IAC) is a very rare pathological lesion occurring in 5 of 1000 autopsy cases, and constitutes 9% of all arachnoid cysts. As a space-occupying mass, IAC may cause headaches, visual disturbances, hypopituitarism, precocious puberty, and the "bobble-head doll" syndrome. The pathogenesis of IAC remains controversial. Magnetic resonance imaging (MRI) is the neurodiagnostic tool of choice to evaluate IAC. The authors presented a 38 year-old woman suffering from severe chronic headaches, dysmenorrhea, and visual disturbance. MRI revealed an intrasellar cystic lesion that had compressed the optic chiasma. Preoperative endocrinological assessment revealed hyperprolactinemia and hypogonadotropic hypogonadism. The patient underwent transsphenoidal surgery. The cyst membrane was opened and clear, serous fluid was evacuated. The postoperative course was complicated by CSF leakage, which was corrected by an autologous fat graft placement. Visual field defects improved immediately after surgery but a transient panhypopituitarism and diabetes insipidus occurred. Postoperative MRI revealed no recurrence of the lesion during the four-year follow-up.
鞍内蛛网膜囊肿（IAC）是一种非常罕见的病理性病变，在1000例尸检病例中出现5例，占所有蛛网膜囊肿的9%。作为一种占位性肿块，IAC可能导致头痛、视觉障碍、垂体功能减退、性早熟和“点头娃娃”综合征。IAC的发病机制仍存在争议。磁共振成像（MRI）是评估IAC的首选神经诊断工具。作者报告了一名38岁女性，患有严重的慢性头痛、痛经和视觉障碍。MRI显示鞍内囊性病变压迫视交叉。术前内分泌评估显示高催乳素血症和低促性腺激素性性腺功能减退。患者接受了经蝶窦手术。打开囊肿包膜，抽出清澈的浆液性液体。术后过程因脑脊液漏而复杂化，通过自体脂肪移植得以纠正。术后视野缺损立即改善，但出现了短暂的全垂体功能减退和尿崩症。术后MRI显示在四年随访期间病变无复发。
