Rehman Lal, Bokhari Iram, Siddiqi Shamim Ul, Bagga Veejay, Hussain Muhammad Masood
Jinnah Postgraduate Medical Centre, Department of Neurosurgery, Karachi, Pakistan.
Turk Neurosurg. 2017 Oct 2. doi: 10.5137/1019-5149.JTN.21095-17.0.
The clinical outcome following surgical resection of intracranial epidermoid lesions is not well documented. We describe a case series evaluating the clinical presentation and outcome following surgery in patients diagnosed with these lesions.
A retrospective study conducted over a 4-year period.
A total 38 patients who underwent surgery for intracranial epidermoid lesions were identified. Of these, 20 were supertentorial and 18 were infratentorial lesions. 33 patients presented with headache. 10 patients with supratentorial lesions presented with seizures. Patients with suprasellar epidermoid lesions presented with headache and visual problems. 14 of the 18 patients with cerebellopontine angle lesions presented with symptoms of trigeminal neuralgia. Post-operatively, 3 patients with cerebellopontine angle tumors developed facial weakness which was transient in 2 patients but permanent in 1 patient. Visual impairment in patients with suprasellar epidermoid lesions improved post-operatively. Hormonal replacement therapy was required in 2 patients. Recovery of 4 patients was complicated by Cerebrospinal fluid (CSF) leak while meningitis developed in 2 patients. One patient operated for cerebellopontine angle epidermoid died post operatively.
Epidermoid lesions can develop anywhere in the cranial cavity. Like other space occupying lesions they often present with symptoms of raised ICP and with specific neurological deficits depending on location of the tumour. Surgical outcome is excellent with low complication rates.
颅内表皮样病变手术切除后的临床结果尚无充分文献记载。我们描述了一组病例,评估了诊断为这些病变的患者手术后的临床表现和结果。
一项为期4年的回顾性研究。
共确定38例接受颅内表皮样病变手术的患者。其中,幕上病变20例,幕下病变18例。33例患者出现头痛。10例幕上病变患者出现癫痫发作。鞍上表皮样病变患者出现头痛和视力问题。18例桥小脑角病变患者中有14例出现三叉神经痛症状。术后,3例桥小脑角肿瘤患者出现面部无力,其中2例为短暂性,1例为永久性。鞍上表皮样病变患者的视力障碍术后有所改善。2例患者需要激素替代治疗。4例患者恢复过程中出现脑脊液漏,2例患者发生脑膜炎。1例接受桥小脑角表皮样病变手术的患者术后死亡。
表皮样病变可发生于颅腔内任何部位。与其他占位性病变一样,它们常表现为颅内压升高症状,并根据肿瘤位置出现特定的神经功能缺损。手术效果良好,并发症发生率低。