Goda K, Tsunoda S, Sakaki T, Nakase H, Yoshimura Y, Sato N, Nakagawa H, Iwasaki S
Department of Neurosurgery, Saiseikai-chuwa Hospital.
No Shinkei Geka. 1990 Aug;18(8):757-60.
While there have been 5 cases of intraventricular arachnoid cyst published in the literature, the occurrence in the anterior horn of the lateral ventricle has not been reported. We report a case of intraventricular arachnoid cyst of the anterior horn causing attacks of orbital pain. A 30-year-old man was admitted with frequent attacks of orbital pain on his right side. Neurological examination revealed no abnormality. Plain CT showed a cystic dilatation of the anterior horn of the right lateral ventricle, and enhanced CT showed a deviation of the septal veins to the left side. T1-weighted MRI demonstrated a low-intensity mass in the anterior horn of the right lateral ventricle, and T2-weighted image demonstrated the mass as having high intensity. PEG in the sitting position showed no filling of air into the right lateral ventricle due to obstruction of the right foramen of Monro. The patient underwent an operation under a diagnosis of intraventricular benign cyst. The cyst wall was subtotally removed and the right foramen of Monro was opened. Histological examination of the specimen showed an arachnoid membrane with prolific collagen fibers. From an embryological point of view, the arachnoid membrane is derived from the arachnoid cell. We think intraventricular arachnoid cysts to originate from the remnants of the arachnoid cell on the tela choroidea or on the choroid plexus like intraventricular meningiomas.
虽然文献中已报道了5例脑室内蛛网膜囊肿,但侧脑室前角出现该囊肿的情况尚未见报道。我们报告1例侧脑室前角脑室内蛛网膜囊肿导致眼眶疼痛发作的病例。一名30岁男性因右侧眼眶频繁疼痛发作入院。神经系统检查未发现异常。平扫CT显示右侧侧脑室前角囊性扩张,增强CT显示间隔静脉向左移位。T1加权磁共振成像显示右侧侧脑室前角有一低强度肿块,T2加权像显示该肿块为高强度。坐位脑室造影显示由于右侧室间孔阻塞,空气未进入右侧脑室。该患者在诊断为脑室内良性囊肿后接受了手术。囊肿壁大部分切除,右侧室间孔开放。标本的组织学检查显示为有大量胶原纤维的蛛网膜。从胚胎学角度来看,蛛网膜由蛛网膜细胞衍生而来。我们认为脑室内蛛网膜囊肿起源于脉络丛或脉络膜上蛛网膜细胞的残余,类似于脑室内脑膜瘤。