Abderrahmen K, Saadaoui K, Bouhoula A, Boubaker A, Jemel H
Service de neurochirurgie, institut national de neurologie de Tunis, faculté de médecine de Tunis, université El Manar, rue Jebbari, La Rabta, 1007 Tunis, Tunisie.
Neurochirurgie. 2012 Oct;58(5):325-30. doi: 10.1016/j.neuchi.2011.12.001. Epub 2012 Jun 28.
Subdural effusions are uncommon but known complications of arachnoid cysts of the middle cranial fossa. They mainly occur after minor head traumas in young patients. Here, we report eight cases of arachnoid cyst of the middle cranial fossa associated with subdural hematoma in five cases and hygroma in three cases. Major symptoms are signs of raised intracranial pressure. CT scan and MRI showed the cyst and the subdural effusion. An excellent therapeutic result was achieved with evacuation of the subdural fluid via burr holes in the five cases of subdural hematoma while in the two cases of hygroma a subduro-peritoneal shunt was necessary. In the last case, a temporal craniotomy was performed with evacuation of the hygroma and fenestration of the cyst. We suggest treating only the complicating event in the case of a subdural hematoma via burr holes evacuation. Whereas, in the case of hygroma we think that craniotomy with fenestration of the cyst or the use of a subdural shunt are more often needed.
硬膜下积液并不常见，但却是中颅窝蛛网膜囊肿已知的并发症。它们主要发生在年轻患者轻微头部外伤后。在此，我们报告8例中颅窝蛛网膜囊肿病例，其中5例合并硬膜下血肿，3例合并硬膜下水瘤。主要症状为颅内压升高的体征。CT扫描和MRI显示了囊肿及硬膜下积液。5例硬膜下血肿患者通过钻孔引流硬膜下液体取得了良好的治疗效果，而3例硬膜下水瘤患者中有2例需要行硬膜下-腹腔分流术。在最后1例患者中，进行了颞部开颅手术，引流硬膜下水瘤并对囊肿进行开窗。我们建议对于硬膜下血肿病例，仅通过钻孔引流处理并发症。而对于硬膜下水瘤，我们认为更常需要进行囊肿开窗的开颅手术或使用硬膜下分流术。
