Del Brutto O H, Guevara J, Sotelo J
Research Division, National Institute of Neurology and Neurosurgery, Mexico, D.F.
J Neurosurg. 1988 Jul;69(1):58-60. doi: 10.3171/jns.1988.69.1.0058.
Eight patients with cysticerci located inside the sella turcica are presented, and the clinical and radiological features of this rare form of neurocysticercosis are discussed. Clinical features included nonspecific ophthalmological and endocrinological disturbances similar to those produced by other sellar lesions. Computerized tomography (CT) usually showed a hypodense mass that simulated either a cystic tumor or an arachnoid cyst. Cerebrospinal fluid (CSF) findings were also nonspecific, as immunological reactions to cysticercosis were most often negative when inflammation was limited to suprasellar and intrasellar regions. An incorrect diagnosis of tumor was frequent in these cases. In contrast, when intrasellar cysticercosis was associated with other forms of neurocysticercosis, proper integration of CT and CSF data permitted an accurate diagnosis. Cysticercosis should be suspected in patients with hypodense juxtasellar lesions living in geographical areas where this disease is endemic. Prompt surgical resection of cysticerci will avoid irreversible damage to visual function.
本文报告了8例位于蝶鞍内的囊尾蚴病患者,并讨论了这种罕见形式的神经囊尾蚴病的临床和放射学特征。临床特征包括与其他鞍区病变相似的非特异性眼科和内分泌紊乱。计算机断层扫描(CT)通常显示一个低密度肿块,类似囊性肿瘤或蛛网膜囊肿。脑脊液(CSF)检查结果也不具有特异性,因为当炎症局限于鞍上和鞍内区域时,对囊尾蚴病的免疫反应大多为阴性。在这些病例中,肿瘤的误诊很常见。相比之下,当鞍内囊尾蚴病与其他形式的神经囊尾蚴病相关时,CT和脑脊液数据的正确整合有助于准确诊断。生活在囊尾蚴病流行地区且有鞍旁低密度病变的患者应怀疑患有囊尾蚴病。及时手术切除囊尾蚴可避免对视功能造成不可逆转的损害。