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成人丹迪-沃克综合征合并脊髓空洞症:一例报告及文献复习

Dandy-Walker syndrome associated with syringomyelia in an adult: a case report and literature review.

作者信息

Zhang Nan, Qi Zhenyu, Zhang Xuewen, Zhong Fangping, Yao Hui, Xu Xiang, Liu Jiangang, Huang Yulun

机构信息

1 Department of Neurosurgery, Daping Hospital, Third Military Medical University, Chongqing, China.

2 Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, Suzhou, China.

出版信息

J Int Med Res. 2019 Apr;47(4):1771-1777. doi: 10.1177/0300060518808961. Epub 2019 Feb 24.

Abstract

Dandy-Walker syndrome associated with syringomyelia is a rare condition, with few reports of adult cases. We describe an adult case of Dandy-Walker syndrome with concomitant syringomyelia. A 33-year-old man presented with a 3-month history of walking instability, numbness in the hands, memory deterioration, and urinary incontinence. A physical examination showed a positive Romberg sign. Brain computed tomography and magnetic resonance imaging showed hydrocephalus, a cyst in the posterior fossa, absence of the cerebellar vermis, hypoplasia of the corpus callosum and cerebella, and syringomyelia. All of these symptoms were consistent with the diagnosis of Dandy-Walker syndrome. Surgery involving arachnoid adhesiolysis and endoscopic third ventriculostomy was performed. At the 6-month follow-up, the symptoms were completely relieved. Magnetic resonance imaging showed that syringomyelia was greatly reduced and the hydrocephalus remained unchanged. Dandy-Walker syndrome with concomitant syringomyelia in adults is exceedingly rare. Early diagnosis and appropriate surgical treatment of this condition should be highlighted. Combined arachnoid adhesiolysis and endoscopic third ventriculostomy may be an effective approach.

摘要

丹迪-沃克综合征合并脊髓空洞症是一种罕见疾病,成人病例报道较少。我们描述一例成人丹迪-沃克综合征合并脊髓空洞症的病例。一名33岁男性,有3个月行走不稳、手部麻木、记忆力减退及尿失禁病史。体格检查显示闭目难立征阳性。脑部计算机断层扫描和磁共振成像显示脑积水、后颅窝囊肿、小脑蚓部缺如、胼胝体和小脑发育不全以及脊髓空洞症。所有这些症状均符合丹迪-沃克综合征的诊断。进行了包括蛛网膜粘连松解术和内镜下第三脑室造瘘术的手术。在6个月的随访中,症状完全缓解。磁共振成像显示脊髓空洞症明显减轻,脑积水无变化。成人丹迪-沃克综合征合并脊髓空洞症极为罕见。应强调对此病的早期诊断和适当的手术治疗。联合蛛网膜粘连松解术和内镜下第三脑室造瘘术可能是一种有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ba/6460593/943e677a1c0f/10.1177_0300060518808961-fig1.jpg

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