Secer H I, Duz B, Solmaz I, Gonul E
Department of Neurosurgery, Gulhane Military Medical Academy, Gülhane Askeri Tip Akademisi Nöroşirürji Kliniği Etlik-Keçiören, Ankara, Turkey.
Minim Invasive Neurosurg. 2010 Jun;53(3):132-7. doi: 10.1055/s-0030-1249013. Epub 2010 Aug 31.
Arachnoid cysts are often associated with subdural hematoma following head trauma. The incidental finding of an aneurysma and a cyst is rare. We describe for the first time the treatment of such a case using endoscopic techniques.
A 44-year-old man was admitted to our hospital with a mild headache and a hemifacial spasm attack at the right side of his face. The radiological examinations demonstrated bilateral slyvian fissure arachnoid cysts and an aneurysm with the dome projecting superolaterally, at the bifurcation of the right middle cerebral artery in the arachnoid cyst. The patient underwent a complete endoscopic surgical clipping of the aneurysm, and partial excision of the right cyst wall and bilateral fenestration to the basal cistern via a single burr-hole craniectomy at the right temporal region. The patient had an uneventful postoperative course without neurological impairment and complication. However, his complaints still persisted postoperatively.
Endoscopic management of arachnoid cysts is an effective and less morbid treatment. This less invasive option might be safe for the clipping of aneurysms within an arachnoid cyst with no additional morbidity for the patient. With smaller operative exposures and yet better visualization offered, neuroendoscopy may reduce operative morbidity.
蛛网膜囊肿常与头部外伤后硬膜下血肿相关。偶然发现动脉瘤和囊肿的情况较为罕见。我们首次描述了使用内镜技术治疗此类病例。
一名44岁男性因轻度头痛和右侧面部半面痉挛发作入院。影像学检查显示双侧外侧裂蛛网膜囊肿以及一个动脉瘤，动脉瘤瘤顶向上外侧突出，位于蛛网膜囊肿内右侧大脑中动脉分叉处。患者接受了动脉瘤的完全内镜手术夹闭，通过右侧颞区单骨孔开颅术进行了右侧囊肿壁部分切除及双侧向基底池开窗。患者术后恢复顺利，无神经功能损害及并发症。然而，其术后仍有症状。
内镜治疗蛛网膜囊肿是一种有效且创伤较小的治疗方法。这种侵入性较小的选择对于夹闭蛛网膜囊肿内的动脉瘤可能是安全的，且不会给患者带来额外的发病率。神经内镜提供了更小的手术暴露范围和更好的视野，可能会降低手术发病率。
