Korsic Marjan, Jugović Domagoj, Porcnik Andrej
Department of Neurosurgery, University Medical Center Ljubljana, Ljubljana, Slovenia.
Acta Clin Croat. 2013 Mar;52(1):119-24.
Interhemispheric cysts, often associated with agenesis of corpus callosum, are rare lesions. The optimal treatment is still controversial. Placement of cystoperitoneal shunt and open microsurgery are traditional treatments. Neuroendoscopy in children is due to its minimal invasiveness a new emerging option. There have been a few published cases on neuroendoscopic treatment of interhemispheric cyst in children. The authors document the youngest reported child with multiloculated interhemispheric cyst that was treated with neuroendoscopy. The cyst was detected in a male fetus in 35th week of gestation and in utero magnetic resonance imaging was performed in 37th week of gestation. After delivery, progressive macrocrania with signs of raised intracranial pressure developed. Endoscopic cystoventriculocisternostomy was performed 28 days after the birth. There was a marked symptom relief. One month after the surgery, magnetic resonance showed shrinkage of the cyst and expansion of the brain parenchyma. After a 2-month follow up period, the child showed normal neurologic development and head circumference increased by only 0.5 cm. The created fenestrations enabled the brain to expand. Neuroendoscopic treatment,of interhemispheric cysts should be considered the operative technique of choice in newborns. Although the intracranial pressure and the size of the cyst have decreased, long-term follow up is necessary and future studies on more cases are needed.
大脑半球间囊肿通常与胼胝体发育不全有关，是一种罕见的病变。最佳治疗方法仍存在争议。囊肿 - 腹腔分流术和开放式显微手术是传统治疗方法。由于其微创性，神经内镜检查在儿童中是一种新兴的选择。关于儿童大脑半球间囊肿的神经内镜治疗，已有少数病例发表。作者记录了报道中最年轻的患有多房性大脑半球间囊肿并接受神经内镜治疗的儿童。该囊肿在一名男性胎儿妊娠35周时被发现，并在妊娠37周时进行了宫内磁共振成像检查。出生后，出现了进行性巨头症并伴有颅内压升高的迹象。出生28天后进行了内镜下囊肿 - 脑室 - 脑池造瘘术。症状明显缓解。手术后一个月，磁共振显示囊肿缩小，脑实质扩张。经过2个月的随访期，该儿童神经发育正常，头围仅增加了0.5厘米。形成的开窗使大脑得以扩张。神经内镜治疗大脑半球间囊肿应被视为新生儿的首选手术技术。尽管颅内压和囊肿大小已经减小，但仍需要长期随访，并且需要对更多病例进行进一步研究。
