Nishijima Yasuo, Fujimura Miki, Nagamatsu Ken-Ichi, Kohama Misaki, Tominaga Teiji
Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Miyagi.
Neurol Med Chir (Tokyo). 2009 Nov;49(11):549-52. doi: 10.2176/nmc.49.549.
A 24-year-old man, who had an asymptomatic septum pellucidum cyst incidentally found one year previously, presented with severe headache and right abducens nerve palsy caused by expansion of the midline cyst. Preoperative magnetic resonance (MR) imaging revealed obstructive hydrocephalus due to the enlarged midline cyst. Neuroendoscopic fenestration of the septum pellucidum cyst was successfully performed via a right frontal approach using a high-resolution flexible neuroendoscopic system without complication. Communication between the cyst cavity and bilateral lateral ventricles was constructed via a single trajectory. The entire inner cyst wall could be inspected from the cyst cavity by manipulating the flexible neuroendoscopic system, which excluded the presence of neoplasm. His symptoms were completely relieved after surgery, and postoperative MR imaging showed significant improvement of hydrocephalus and shrinkage of the midline cyst. Septum pellucidum cavum vergae cyst may expand and become symptomatic, so fenestration using a flexible neuroendoscope system may be the optimal method for constructing communication to the bilateral lateral ventricles with minimal invasion.
一名24岁男性，一年前偶然发现有无症状的透明隔囊肿，现因中线囊肿扩大出现严重头痛和右侧展神经麻痹。术前磁共振成像显示因中线囊肿增大导致梗阻性脑积水。使用高分辨率软性神经内镜系统经右额入路成功进行了透明隔囊肿神经内镜开窗术，无并发症。通过单一径路建立了囊肿腔与双侧侧脑室之间的交通。通过操作软性神经内镜系统可从囊肿腔内检查整个囊肿内壁，排除了肿瘤的存在。术后其症状完全缓解，术后磁共振成像显示脑积水明显改善，中线囊肿缩小。透明隔腔囊肿可能会扩大并出现症状，因此使用软性神经内镜系统开窗术可能是微创建立与双侧侧脑室交通的最佳方法。
