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桥小脑角肿瘤手术后症状性硬脑膜下积液的自发消退。

Spontaneously Resolving Symptomatic Subdural Hygromas After Cerebellopontine Angle Tumor Surgery.

机构信息

Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.

Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.

出版信息

World Neurosurg. 2018 Feb;110:35-38. doi: 10.1016/j.wneu.2017.10.114. Epub 2017 Oct 31.

Abstract

BACKGROUND

Subdural hygroma is a rare disease most commonly encountered in posttraumatic patients. Even more rarely, it has been described as a complication of cerebellopontine angle tumor requiring surgical evacuation.

CASE DESCRIPTION

This report discusses 2 patients who underwent surgery for cerebellopontine angle tumor and who both developed symptomatic subdural hygromas a few days later. Both became highly symptomatic but symptoms resolved spontaneously and promptly before planned surgery.

CONCLUSIONS

These 2 cases highlight the 2 principal pathogenesis theories for the development of subdural hygromas (arachnoid tear and effusion) and suggest a theory for their sudden and spontaneous resolution: the pressure equilibrium opening the valve created by the arachnoid tear. Eventhough surgical treatment remains the recommended attitude, these cases show that conservative treatment can be an option in some cases.

摘要

背景

硬脑膜下水肿是一种罕见的疾病,最常见于创伤后患者。更罕见的是,它被描述为桥小脑角肿瘤的并发症,需要手术清除。

病例描述

本报告讨论了 2 例因桥小脑角肿瘤而行手术的患者,他们均在术后数天出现症状性硬脑膜下水肿。这 2 例患者均出现严重症状,但在计划手术前症状自发性迅速缓解。

结论

这 2 个病例强调了硬脑膜下水肿(蛛网膜撕裂和渗出)发展的 2 个主要发病机制理论,并提出了一个关于其突然自发缓解的理论:蛛网膜撕裂产生的压力平衡打开了阀门。尽管手术治疗仍然是推荐的治疗方法,但这些病例表明,在某些情况下,保守治疗也是一种选择。

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