一项基于人群的颅内蛛网膜囊肿研究：成人手术囊肿减压后的临床和神经影像学结果
A population based study of intracranial arachnoid cysts: clinical and neuroimaging outcomes following surgical cyst decompression in adults.
作者信息
Helland Christian A, Wester Knut
机构信息
Section for Neurosurgery, Department of Surgical Sciences, University of Bergen, and Haukeland University Hospital, Bergen, Norway.
出版信息
J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1129-35. doi: 10.1136/jnnp.2006.107995. Epub 2007 Feb 13.
BACKGROUND
We have gradually adopted a liberal attitude towards surgical decompression of arachnoid cysts. This study describes the results from our institution.
METHODS
Long term clinical and neuroimaging results of 156 adult patients (aged > or = 16 years) operated on for arachnoid cysts in our department during the period January 1987 to September 2004 were assessed based on their medical and neuroimaging records, and on a questionnaire.
RESULTS
The clinical and/or neuroimaging results indicated that the cyst was successfully decompressed in all patients. 82% of patients were asymptomatic or had insignificant complaints at follow-up. 12% reported no symptom relief whereas 6% experienced worsening of symptoms. The cyst disappeared after surgery, or was reduced to < 50% of the preoperative volume, in 66% of cases. In another 24%, the postoperative volume was also reduced, but was larger than 50% of the original cyst volume. No reduction in fluid volume was observed in 10% of cases. There was no association between volume reduction and clinical improvement. A complication occurred in 26 patients (17%), all with temporal cysts, leading to reoperation in 11 patients (7.1%). In only two patients did the complication cause a permanent slight disability.
CONCLUSION
Decompression of arachnoid cysts yields a substantial clinical benefit with a low risk of severe complications.
背景
我们对外科手术减压治疗蛛网膜囊肿已逐渐采取较为宽松的态度。本研究描述了我们机构的治疗结果。
方法
根据1987年1月至2004年9月期间在我科接受蛛网膜囊肿手术的156例成年患者（年龄≥16岁）的病历和神经影像学记录以及一份调查问卷，对其长期临床和神经影像学结果进行评估。
结果
临床和/或神经影像学结果表明所有患者的囊肿均成功减压。82%的患者在随访时无症状或仅有轻微不适。12%的患者报告症状未缓解，而6%的患者症状加重。66%的病例中囊肿在术后消失，或缩小至术前体积的<50%。在另外24%的病例中，术后囊肿体积也有所减小，但大于原始囊肿体积的50%。10%的病例中未观察到液体量减少。囊肿体积缩小与临床改善之间无关联。26例患者（17%）出现并发症，均为颞叶囊肿，其中11例患者（7.1%）因此接受了再次手术。仅2例患者的并发症导致了永久性轻度残疾。
结论
蛛网膜囊肿减压可带来显著的临床益处，严重并发症风险较低。
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