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手术切除成人起病的颅咽管瘤逆转术前紧张症状态:病例报告及文献复习

Reversal of preoperative catatonic state by surgical resection of an adult-onset craniopharyngioma: case report and review of the literature.

作者信息

Massengale Justin, Tafti Bashir Akhavan, Large Lisa, Skirboll Stephen

机构信息

Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Cogn Behav Neurol. 2009 Mar;22(1):67-71. doi: 10.1097/WNN.0b013e318192cc9e.

Abstract

OBJECTIVE

To describe a case of a rare adult-onset craniopharyngioma presenting as rapidly progressive catatonia that was reversed after surgical resection of the tumor.

BACKGROUND

Profoundly depressed states of awareness classified as either catatonia or akinetic mutism have been reported in patients with hypothalamic neoplasms, but reports of improvement in consciousness level after surgical resection are rare and limited to very large tumors.

METHOD

Medical, neurologic, and psychiatric histories, physical examination findings, laboratory workup results, pathologic and imaging studies, and response to surgical treatment were documented.

RESULT

The patient showed progressive improvement in mental status and overall neurologic function after surgical treatment.

CONCLUSIONS

The search for an etiology of a profound catatonic state should include the probability of a suprasellar/hypothalamic lesion, which in this case was owing to the rare finding of an imaging-documented adult-onset craniopharyngioma.

摘要

目的

描述一例罕见的成年起病的颅咽管瘤病例,该病例表现为快速进展的紧张症,肿瘤手术切除后症状得到缓解。

背景

下丘脑肿瘤患者中曾有报道出现深度意识障碍,表现为紧张症或运动不能性缄默,但手术切除后意识水平改善的报道罕见,且仅限于非常大的肿瘤。

方法

记录患者的医学、神经学和精神病史、体格检查结果、实验室检查结果、病理和影像学研究以及手术治疗反应。

结果

手术治疗后患者的精神状态和整体神经功能逐渐改善。

结论

对于深度紧张症状态病因的排查应包括鞍上/下丘脑病变的可能性,在本病例中是由于影像学证实的成年起病的颅咽管瘤这一罕见发现。

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