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伴有双侧眼眶扩展的鼻筛部脑膨出:西方国家1例病例报告

Naso-ethmoidal encephalocele with bilateral orbital extension: report of a case in a western country.

作者信息

Secci Francesca, Consales Alessandro, Merciadri Paolo, Ravegnani Giuseppe Marcello, Piatelli Gianluca, Pavanello Marco, Cama Armando

机构信息

Department of Neurosurgery, Giannina Gaslini Children's Research Hospital (IRCSS), Largo Gerolamo Gaslini 5, Genoa, Italy.

出版信息

Childs Nerv Syst. 2013 Oct;29(10):1947-52. doi: 10.1007/s00381-013-2125-5. Epub 2013 Jun 19.

Abstract

INTRODUCTION

Encephalocele is a rare congenital malformation of the central nervous system with protrusion of cranial content (meninges, brain, and ventricles in different combinations) beyond the normal confines of the skull. Anterior encephaloceles occur with a high frequency in Southeast Asia, while in the Western countries occipital encephaloceles prevail. The treatment of an anterior (naso-ethmoidal) encephalocele involves a neurosurgeon or a multidisciplinary team (neurosurgeon, maxillofacial surgeon, plastic surgeon, and ENT surgeon) dealing with craniofacial surgery. Goals of surgery include removal or repositioning of nonfunctional cerebral tissue, closure of the dura, and reconstruction of skeletal and cutaneous structures. The prognosis depends from the anatomical site, volume of neural contents, and the presence of coexisting malformations.

CASE REPORT

We report the case of an Italian child suffering from a naso-ethmoidal encephalocele with bilateral orbital extension. The surgical treatment was performed in two steps.

CONCLUSION

Sincipital encephalocele is a complex pathology without a unique standardized surgical treatment. Its low incidence in Western countries can make its management particularly tricky.

摘要

引言

脑膨出是一种罕见的中枢神经系统先天性畸形,颅骨内容物(脑膜、脑和脑室以不同组合形式)突出于颅骨正常边界之外。前脑膨出在东南亚地区高发,而在西方国家枕部脑膨出更为常见。前(鼻 - 筛骨)脑膨出的治疗需要神经外科医生或多学科团队(神经外科医生、颌面外科医生、整形外科医生和耳鼻喉科医生)进行颅面外科手术。手术目标包括切除或重新定位无功能的脑组织、封闭硬脑膜以及重建骨骼和皮肤结构。预后取决于解剖部位、神经内容物的体积以及是否存在合并畸形。

病例报告

我们报告一例患有双侧眶部扩展的鼻 - 筛骨脑膨出的意大利儿童病例。手术治疗分两步进行。

结论

额部脑膨出是一种复杂的病症,没有独特的标准化手术治疗方法。其在西方国家发病率较低,这使得其治疗尤为棘手。

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