Diyora Batuk, Bhende Bhagyashri, Dhall Gagan, Patil Aditya, Nayak Naren
Department of Neurosurgery, Lokmanya Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India.
Department of Neurosurgery, Lokmanya Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India.
World Neurosurg. 2019 Feb;122:577-582. doi: 10.1016/j.wneu.2018.11.107. Epub 2018 Nov 22.
Craniovertebral junction arachnoid cysts are uncommon. Among those reported, ventrally located arachnoid cysts at the extremes of age have been even rarer. We report a successfully managed case of a ventrally placed arachnoid cyst in an 88-year-old man using an unconventional surgical approach.
An 88-year-old man presented to us with complaints of tingling and numbness in both upper and lower limbs. He had a weak handgrip on both sides. Spinal magnetic resonance imaging (MRI) showed a non-contrast-enhancing cystic lesion over the anterior lip of the foreman magnum that had displaced the cervicomedullary junction posteriorly. The lesion was homogenously hypointense on T1-weighted MRI and hyperintense on T2-weighted MRI. The lesion was excised using a posterior approach. The cyst contents were drained, followed by complete wall excision. Complete improvement in clinical symptoms and an absence of neurological deficits were noted in the patient.
Arachnoid cysts are congenital lesions and can present at the extremes of age. Ventrally placed small symptomatic arachnoid cysts can be managed successfully through the posterior approach, especially in the elderly population.
颅颈交界区蛛网膜囊肿并不常见。在已报道的病例中，位于腹侧且发生于年龄极值阶段的蛛网膜囊肿更为罕见。我们报告一例采用非常规手术方法成功治疗的88岁男性腹侧蛛网膜囊肿病例。
一名88岁男性因双上肢和双下肢刺痛及麻木前来就诊。他双侧握力减弱。脊柱磁共振成像（MRI）显示枕骨大孔前缘有一个无强化的囊性病变，该病变将颈髓交界处向后推移。在T1加权MRI上，病变呈均匀低信号，在T2加权MRI上呈高信号。采用后路手术切除病变。排出囊肿内容物，随后完整切除囊肿壁。患者临床症状完全改善，且无神经功能缺损。
蛛网膜囊肿是先天性病变，可在年龄极值阶段出现。腹侧较小的有症状蛛网膜囊肿可通过后路手术成功治疗，尤其是在老年人群中。
