Bhatia Robin, Anderson Stuart, Bradley Veronica, Akinwunmi James A
Department of Neurosurgery, Hurstwood Park Neurological Centre, Haywards Heath, West Sussex, United Kingdom.
Appl Neuropsychol. 2008;15(4):293-7. doi: 10.1080/09084280802312478.
This report presents a case of a 39-year-old male with a spontaneously ruptured frontotemporal dermoid cyst. Intraoperatively, during surgical resection of the cyst, significant fat spillage occurred associated with a profound anterior circulation vasospasm. The patient underwent serial neuropsychological evaluation over five months, revealing a profile of initial deterioration, followed by delayed recovery of cognitive function. A review of the literature reveals three other case reports describing ischemic deficit after dermoid rupture, but the cognitive impairment associated with this pathology has never been formally profiled before, and it may be possible to draw analogies to the well-established ischemic deficit post-subarachnoid hemorrhage found in the literature. Neuropsychological profiling additionally informs us about the nature and progression of this entity from a cognitive perspective and whether the etiology of deficit caused by dermoid rupture could be localized, or global, secondary to diffuse fatty dissemination in the CSF.
本报告介绍了一例39岁男性自发性额颞部皮样囊肿破裂的病例。术中，在囊肿手术切除过程中，发生了大量脂肪溢出，并伴有严重的前循环血管痉挛。患者在五个月内接受了系列神经心理学评估，结果显示最初认知功能恶化，随后认知功能延迟恢复。文献回顾发现另外三篇病例报告描述了皮样囊肿破裂后的缺血性缺陷，但此前从未对与该病理相关的认知障碍进行过正式描述，并且有可能与文献中已明确的蛛网膜下腔出血后缺血性缺陷进行类比。神经心理学分析还从认知角度告知我们该疾病的性质和进展情况，以及皮样囊肿破裂导致的缺陷病因是局部性的，还是由于脑脊液中弥漫性脂肪播散引起的全身性的。
