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胸椎硬膜内蛛网膜囊肿手术后并发脑积水:一例报告

Hydrocephalus Following Surgery of Thoracic Intradural Arachnoid Cyst: A Case Report.

作者信息

Ozger Ozkan, Kaplan Necati

机构信息

Istinye University, Faculty of Medicine, Canakkale Anadolu Hospital, Department of Neurosurgery, Canakkale, Turkey.

出版信息

Turk Neurosurg. 2020;30(2):307-311. doi: 10.5137/1019-5149.JTN.26870-19.3.

Abstract

Spinal intradural arachnoid cysts (SIACs) are cerebrospinal fluid (CSF) sacs formed by arachnoid membranes. They may be idiopathic or acquired. Treatment is resection, fenestration, or cyst drainage. A 41-year-old female patient presented with myelopathy symptoms and complaints. Magnetic resonance imaging (MRI) revealed a T6-T10 dorsal intradural arachnoid cyst. A T6-T10 laminectomy was performed and an arachnoid cyst was excised under surgical microscope. The cyst contained a clear liquid that was surrounded by a transparent membrane. At 7 weeks postoperatively, the patient experienced severe headache, excessive sleepiness, vomiting, loss of coordination, difficulty walking, and difficulty concentrating. A head computed tomography (CT) scan showed marked ventricular dilation that was diagnosed as delayed hydrocephalus. The patient underwent ventriculoperitoneal shunt (VPS) placement one day after admission. This is a rare condition of hydrocephalus that develops due to CSF leakage after SIAC surgery.

摘要

脊髓硬膜内蛛网膜囊肿(SIACs)是由蛛网膜形成的脑脊液(CSF)囊。它们可能是特发性的或后天获得的。治疗方法是切除、开窗或囊肿引流。一名41岁女性患者出现脊髓病症状并前来就诊。磁共振成像(MRI)显示T6 - T10节段的硬膜内蛛网膜囊肿。进行了T6 - T10椎板切除术,并在手术显微镜下切除了蛛网膜囊肿。囊肿内含有清澈液体,周围有一层透明膜。术后7周,患者出现严重头痛、过度嗜睡、呕吐、共济失调、行走困难和注意力不集中。头部计算机断层扫描(CT)显示明显的脑室扩张,诊断为迟发性脑积水。患者入院一天后接受了脑室腹腔分流术(VPS)。这是一种由于SIAC手术后脑脊液漏导致的罕见脑积水情况。

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