Tsuboi Yoshifumi, Hayashi Nakamasa, Noguchi Kyo, Kurimoto Masanori, Nagai Shoichi, Endo Shunro
Department of Neurosurgery, Faculty of Medicine, University of Toyama, Japan.
Neurol Med Chir (Tokyo). 2007 May;47(5):240-1. doi: 10.2176/nmc.47.240.
A 66-year-old man presented with a parietal intradiploic encephalocele manifesting as dizziness in June 2001. Skull radiography showed lytic change involving the right parietal bone. Computed tomography with bone window showed bone destruction associated with the right frontal lesion. Magnetic resonance imaging demonstrated a lesion in the parietal intradiploic space continuous with the right frontal lobe. The lesion was located near the central sulcus, so surgical biopsy carried the risk of motor dysfunction. Single photon emission computed tomography (SPECT) showed the same pattern of cerebral blood flow as normal brain tissue, so the neuroimaging diagnosis was encephalocele. The present case indicates that surgery may not be necessary in the absence of symptoms and neurological deficits. SPECT is very useful to identify encephalocele.
一名66岁男性于2001年6月因顶叶板障内脑膨出伴头晕就诊。颅骨X线摄影显示右侧顶骨有骨质溶解改变。骨窗计算机断层扫描显示右侧额叶病变伴有骨质破坏。磁共振成像显示顶叶板障内有一病变，与右侧额叶相连。病变位于中央沟附近，因此手术活检有导致运动功能障碍的风险。单光子发射计算机断层扫描（SPECT）显示脑血流模式与正常脑组织相同，因此神经影像学诊断为脑膨出。本例表明，在没有症状和神经功能缺损的情况下可能无需手术。SPECT对脑膨出的诊断非常有用。
