Kim Jun-Hoe, Wang Kyu-Chang, Phi Ji Hoon, Park Sung-Hye, Cheon Jung-Eun, Kim Seung-Ki
Division of Pediatric Neurosurgery, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110744, Republic of Korea.
Department of Pathology, College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110744, Republic of Korea.
Childs Nerv Syst. 2018 Dec;34(12):2491-2495. doi: 10.1007/s00381-018-3892-9. Epub 2018 Jul 6.
Intracranial neurenteric cysts are rare and are not often found in the supratentorial space. We present a case of an intracranial neurenteric cyst that arose at the suprasellar cistern with extension to the middle cranial fossa.
A 3-year-old girl presented with seizure. Neuroimaging showed a huge extra-axial cyst involving the suprasellar cistern and left middle cranial fossa. Under the impression of an arachnoid cyst, she underwent fenestration of the cyst with basal cisterns and ventricle. The pathologic diagnosis was neurenteric cyst. Four years after the surgery, MRI showed no recurrence but did show poorly developed myelination of the left temporal white matter. Three years after surgery, seizures recurred. We consider epilepsy surgery in case of uncontrolled seizure.
We discuss the unique case of supratentorially located neurenteric cyst that is just treated by fenestration. A close follow-up is needed for children with intracranial neurenteric cysts to surveil not only recurrence of lesion but also normal brain development.
颅内神经肠囊肿罕见,在幕上空间较少见。我们报告一例起源于鞍上池并延伸至中颅窝的颅内神经肠囊肿病例。
一名3岁女孩出现癫痫发作。神经影像学检查显示一个巨大的轴外囊肿,累及鞍上池和左侧中颅窝。在蛛网膜囊肿的诊断下,她接受了囊肿与基底池和脑室的造瘘手术。病理诊断为神经肠囊肿。手术后四年,MRI显示无复发,但显示左侧颞叶白质髓鞘发育不良。手术后三年,癫痫复发。如果癫痫发作无法控制,我们考虑进行癫痫手术。
我们讨论了仅通过造瘘治疗的幕上神经肠囊肿这一独特病例。颅内神经肠囊肿患儿需要密切随访,以监测病变复发及脑发育是否正常。