Rezaee Omidvar, Ebrahimzadeh Kaveh, Maloumeh Ehsan Nazari, Jafari Armin, Shafizad Misagh, Hallajnejad Mohammad
Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Surg Neurol Int. 2017 Dec 6;8:289. doi: 10.4103/sni.sni_247_17. eCollection 2017.
Arachnoid cysts are found everywhere in cerebrospinal axis, most often in the middle cranial fossa. They are very rare in prepontine location.
In this study, we report a 26-year-old female presenting with a 3-month history of headache and diplopia. On physical examination, she had clinical manifestations of sixth cranial nerve palsy. Magnetic resonance imaging revealed a prepontine arachnoid cyst with extension into interpeduncular and suprasellar cisterns. Computed tomography scan demonstrated no evidence of hydrocephalus. The patient was treated surgically by endoscopic fenestration of the cyst with endonasal transsphenoidal approach. The cyst was opened to prepontine, interpeduncular, and suprasellar cisterns.
Endoscopic endonasal fenestration of the cyst to adjacent cistern may be safe in prepontine arachnoid cysts with sellar and suprasellar extension; it may be effective and less invasive compare to transcranial approach.
蛛网膜囊肿可见于脑脊髓轴的任何部位，最常见于中颅窝。桥前部位的蛛网膜囊肿非常罕见。
在本研究中，我们报告了一名26岁女性，有3个月的头痛和复视病史。体格检查时，她有第六颅神经麻痹的临床表现。磁共振成像显示桥前蛛网膜囊肿延伸至脚间池和鞍上池。计算机断层扫描未发现脑积水迹象。该患者通过鼻内镜经蝶窦入路对囊肿进行内镜开窗手术治疗。囊肿被打开至桥前池、脚间池和鞍上池。
对于延伸至鞍区和鞍上区的桥前蛛网膜囊肿，经鼻内镜对囊肿与相邻脑池进行开窗手术可能是安全的；与经颅手术相比，它可能有效且侵袭性较小。
