Sugata Jun, Ueda Tessei, Tanoue Natsuko, Hirahara Kazuho, Kamimura Kiyohisa, Arita Kazunori, Yoshimoto Koji
1 Department of Neurosurgery, Kagoshima University, Japan.
2 Department of Neurosurgery, Izumi Regional Hospital, Japan.
Neuroradiol J. 2019 Apr;32(2):98-102. doi: 10.1177/1971400918821085. Epub 2019 Jan 3.
An otherwise healthy 22-month-old boy suffered high fever, irritability, nausea, dysphagia, dysarthria and right hemiparesis. Magnetic resonance imaging showed a cystic mass, 15 mm in diameter, with surrounding oedema in the base of the lower pons. The symptoms subsided in about 10 days after onset, followed by a rapid decrease of the cyst size to 5 mm. Thereafter, the patient's psychomotor growth has been normal. Annual follow-up magnetic resonance imaging scans showed very gradual enlargement of the cyst located on the ventral surface of the pontomedullary junction, reaching 16 mm in diameter in 21 years after onset. It was hyperintense on T1-weighted and isointense on T2-weighted magnetic resonance imaging. No haemosiderin deposition or gadolinium enhancement was seen. This is a rare report of a two decade longitudinal follow-up of a midline prepontine cyst showing asymptomatic and very slow growth. The possible nature of the cyst includes neurenteric, dermoid and epidermoid cyst.
一名原本健康的22个月大男孩出现高热、易怒、恶心、吞咽困难、构音障碍和右侧偏瘫。磁共振成像显示在脑桥下部底部有一个直径15毫米的囊性肿块，周围伴有水肿。症状在发病后约10天消退，随后囊肿大小迅速缩小至5毫米。此后，患者的精神运动发育一直正常。每年的随访磁共振成像扫描显示，位于脑桥延髓交界处腹侧表面的囊肿非常缓慢地增大，发病21年后直径达到16毫米。在T1加权磁共振成像上呈高信号，在T2加权磁共振成像上呈等信号。未见含铁血黄素沉积或钆增强。这是一份罕见的关于脑桥前正中囊肿长达20年纵向随访的报告，显示其无症状且生长非常缓慢。囊肿的可能性质包括神经肠囊肿、皮样囊肿和表皮样囊肿。
