Department of Neurosurgery and Pediatric Neurosurgery, Pomeranian Medical University in Szczecin.
Department of Neurosurgery and Neurotraumatology, Regional Public Hospital.
Neurol Med Chir (Tokyo). 2020 Apr 15;60(4):202-208. doi: 10.2176/nmc.oa.2019-0001. Epub 2020 Mar 5.
Cysts of the septum pellucidum (CSP) are usually asymptomatic; however, in some cases they can begin expanding and cause neurological deterioration. The mechanism leading to the formation of an expanding cyst of the septum pellucidum (ECSP) is not known. Based on observations made during endoscopic treatment of ECSP we analyzed intraoperative findings in respect to cyst formation mechanism and treatment prognosis. A group of 31 patients was studied. Only cases with bulging cyst walls occupying the frontal horns observed on imaging studies were included. The main symptom was a severe, intermittent headache. In three cases short term memory deficits were diagnosed. In one case papilloedema was observed. All patients underwent endoscopic fenestration of the ECSP. There were no cases of cyst reocclusion during a follow-up period of 1-14 years (mean 6.2 years). In 30 cases headaches resolved completely and in one case its intensity was significantly smaller. There was one case of postoperative hemiparesis. In all but two cases the thin, translucent region in the anterior part of the cyst floor was found. In the region small fissures and in three cases choroid plexus were observed. Endoscopic fenestration is the efficient treatment for ECSP. ECSP is formed on the basis of not completely closed, developmental communication of the cyst with other fluid spaces. The communication is opened by transient elevation of intraventricular pressure, and acts as a valve leading to fluid accumulation among the walls of the previously asymptomatic cavum septum pellucidum.
透明隔囊肿（CSP）通常无症状；然而，在某些情况下，它们可能开始扩张并导致神经功能恶化。导致透明隔囊肿扩张（ECSP）形成的机制尚不清楚。基于对 ECSP 内镜治疗的观察，我们分析了术中发现与囊肿形成机制和治疗预后的关系。研究了一组 31 例患者。仅包括影像学检查观察到凸向额角的囊壁膨出的病例。主要症状是严重间歇性头痛。在 3 例中诊断为短期记忆障碍。1 例出现视乳头水肿。所有患者均接受了 ECSP 的内镜开窗术。在 1 至 14 年（平均 6.2 年）的随访期间无囊肿再闭塞病例。30 例头痛完全缓解，1 例头痛强度明显减小。1 例术后偏瘫。除 2 例外，所有患者均在前部囊底发现薄而透明的区域。在该区域观察到小裂隙，在 3 例中观察到脉络丛。内镜开窗术是 ECSP 的有效治疗方法。ECSP 是基于囊肿与其他液体空间不完全闭合的发育性交通形成的。交通通过短暂升高脑室压力而开放，起到瓣膜的作用，导致原本无症状的透明隔腔壁之间的液体积聚。
