Prajsnar-Borak Anna, Oertel Joachim, Antes Sebastian, Yilmaz Umut, Linsler Stefan
Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Gebäude 90.5, 66421, Homburg/Saar, Germany.
Department of Neuroradiology, Faculty of Medicine, Saarland University Medical Center and Saarland University, Homburg, Germany.
Childs Nerv Syst. 2019 Apr;35(4):695-699. doi: 10.1007/s00381-018-4011-7. Epub 2018 Nov 28.
Intracranial arachnoid cysts (ACs) represent rare extra-axial CSF-containing lesions. Surgical management mainly depends on the cyst location and its size. Nevertheless, pure endoscopic fenestration represents a relatively straightforward and safe technique, and-in most cases-the treatment of choice for symptomatic intracranial ACs. The postoperative complication rate of the procedure is low including subdural hematomas, hygromas, and intraparenchymal hemorrhages. Symptomatic cerebral vasospasm after endoscopic treatment of ACs is a very uncommon event.
CASE REPORT/RESULTS: To the authors' knowledge, this adverse event in children has not yet been reported in the literature yet. The authors present a case of a 9-year-old child developing an early symptomatic cerebral vasospasm with an insignificant secondary ischemia following endoscopic fenestration of a large temporal arachnoid cyst.
The clinical approach, possible pathogenesis, and the therapeutic strategy is discussed particularly with regard to the literature.
颅内蛛网膜囊肿（ACs）是罕见的含脑脊液的轴外病变。手术治疗主要取决于囊肿的位置及其大小。然而，单纯内镜下造瘘是一种相对简单且安全的技术，并且在大多数情况下是有症状的颅内ACs的首选治疗方法。该手术的术后并发症发生率较低，包括硬膜下血肿、积液和脑实质内出血。内镜治疗ACs后出现有症状的脑血管痉挛是非常罕见的事件。
病例报告/结果：据作者所知，儿童中的这一不良事件尚未见文献报道。作者报告了一例9岁儿童，在对一个大的颞叶蛛网膜囊肿进行内镜下造瘘后出现早期有症状的脑血管痉挛，并伴有轻微的继发性缺血。
特别结合文献讨论了临床处理方法、可能的发病机制和治疗策略。
