Hasegawa M, Yamashima T, Yamashita J, Kuroda E
Department of Neurosurgery, Kanazawa University School of Medicine, Japan.
Surg Neurol. 1991 May;35(5):355-9. doi: 10.1016/0090-3019(91)90044-a.
A case of a large symptomatic intrasellar arachnoid cyst with suprasellar extension is reported. A 53-year-old man was admitted because of decreased visual acuity. Magnetic resonance imaging showed a large intrasellar cyst extending into the suprasellar cistern, with compression of optic nerves. The intensity of the cyst was identical to that of the surrounding subarachnoid space on both T1-, T2-, and proton density-weighted images. Transsphenoidal surgery was performed, but subsequent refilling of the cyst required additional transcranial surgery. Analysis of the cerebrospinal fluid-like cystic fluid revealed high levels of protein and pituitary hormones. Histological study revealed that the cyst wall was composed of connective tissue and arachnoid cells, which were ultrastructurally characterized by a number of desmosomes. Diagnostic, surgical, and pathological features of intrasellar arachnoid cysts are discussed.
报告了一例有症状的鞍内蛛网膜囊肿并向上延伸至鞍上的病例。一名53岁男性因视力下降入院。磁共振成像显示一个大的鞍内囊肿延伸至鞍上池，压迫视神经。在T1加权、T2加权和质子密度加权图像上，囊肿的信号强度与周围蛛网膜下腔相同。进行了经蝶窦手术，但囊肿随后再次充盈，需要额外的经颅手术。对脑脊液样囊液的分析显示蛋白质和垂体激素水平升高。组织学研究显示囊肿壁由结缔组织和蛛网膜细胞组成，超微结构特征为有许多桥粒。讨论了鞍内蛛网膜囊肿的诊断、手术和病理特征。
