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婴儿巨大颅脊髓髓内神经肠囊肿——病例报告及文献综述

Giant Craniospinal Intramedullary Neurenteric Cyst in Infant-Case Report and Review of Literature.

作者信息

Diyora Batuk, Bhende Bhagyashri, Kukreja Sanjay

机构信息

Department of Neurosurgery, LTMGH & LTMMC, Mumbai, Maharashtra, India.

Department of Neurosurgery, LTMGH & LTMMC, Mumbai, Maharashtra, India.

出版信息

World Neurosurg. 2018 Oct;118:126-131. doi: 10.1016/j.wneu.2018.07.027. Epub 2018 Aug 4.

Abstract

BACKGROUND

Neurenteric cysts are rare congenital lesions derived from an anomalous connection between the primitive ectoderm and endoderm.

CASE DESCRIPTION

A 2-month-old infant presented with an insidious onset of upper limb weakness. Magnetic resonance imaging of the spine revealed a contrast-enhancing solid mass located anterior to the spinal cord at the level of the cervicothoracic junction, which was isointense on T1-weighted images and hyperintense on T2-weighted images. The lesion was associated with marked spinal cord compression and also with a giant intramedullary cyst that extended proximally into the cranium. Spinal dysraphism was noted. The patient underwent cervicothoracic laminotomy, drainage of the cyst contents, and a complete excision of the solid component. Neurologic function recovery was observed postoperatively.

CONCLUSIONS

We report and discuss the clinical presentation, pathogenesis, and neuroradiologic findings in an infantile case of a giant craniospinal intramedullary neurenteric cyst. Early recognition is beneficial because of its benign nature and good clinical outcome following total surgical resection.

摘要

背景

神经肠囊肿是一种罕见的先天性病变,起源于原始外胚层和内胚层之间的异常连接。

病例描述

一名2个月大的婴儿出现隐匿性上肢无力。脊柱磁共振成像显示在颈胸交界处脊髓前方有一个强化的实性肿块,在T1加权图像上呈等信号,在T2加权图像上呈高信号。该病变伴有明显的脊髓压迫,还伴有一个巨大的髓内囊肿,囊肿向近端延伸至颅骨。发现有脊柱裂。患者接受了颈胸椎板切开术、囊肿内容物引流以及实性成分的完整切除。术后观察到神经功能恢复。

结论

我们报告并讨论了一例婴儿巨大颅脊髓髓内神经肠囊肿的临床表现、发病机制和神经放射学表现。由于其良性性质以及全手术切除后良好的临床结果,早期识别是有益的。

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