Department of Neurosurgery, International Neuroscience Institute, 4 Rudolf-Pichlmayer-Straße, 30625 Hannover, Germany.
J Clin Neurosci. 2012 Mar;19(3):472-3. doi: 10.1016/j.jocn.2011.04.035. Epub 2012 Jan 25.
Ganglion cysts (ganglia) are benign lesions of the soft tissue arising in the periarticular space. We present a 54-year-old woman with a 5-month history of headache and weakness of the tongue with deviation to the left side who had a rare extraneural intradural bilobate ganglion cyst of the atlanto-occipital joint compressing the hypoglossal nerve. An MRI showed a bilobate cystic lesion in the premedullary cistern on the left side at the level of the hypoglossal canal. This lesion was removed using a lateral suboccipital approach in the semi-sitting position with removal of the C1 hemiarch. The lesion proved to be a ganglion cyst on histopathology. Intracranial juxtafacet (ganglion and synovial) cysts compressing the hypoglossal nerve should be considered in the differential diagnosis with other lesions of this region. Although there was no recurrence at 30-month follow-up, there was no significant improvement of the tongue weakness. We describe our surgical strategy and discuss the pathogenesis of the cyst.
神经节囊肿（神经节）是起源于关节周围间隙的软组织良性病变。我们报告了一例 54 岁女性，头痛 5 个月，伴有左侧舌肌无力和偏向，寰枕关节罕见的神经外硬脊膜内双叶状神经节囊肿压迫舌下神经。MRI 显示在舌下神经管水平的延髓前池左侧有一个双叶囊性病变。该病变采用半坐位下侧枕下入路切除 C1 半弓，切除病变。组织病理学证实为神经节囊肿。颅内关节突旁（神经节和滑膜）囊肿压迫舌下神经，应与该区域其他病变进行鉴别诊断。虽然在 30 个月的随访中没有复发，但舌肌无力没有明显改善。我们描述了我们的手术策略，并讨论了囊肿的发病机制。
