Irie Kohei, Shimogawa Takafumi, Mukae Nobutaka, Kuga Daisuke, Iwaki Toru, Mizoguchi Masahiro, Yoshimoto Koji
Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
Department of Neuropathology, Kyushu University, Fukuoka, Japan.
Surg Neurol Int. 2022 Mar 25;13:102. doi: 10.25259/SNI_133_2022. eCollection 2022.
Glioependymal cysts (GECs) are rare, benign congenital intracranial cysts that account for 1% of all intracranial cysts. Surgical interventions are required for patients with symptomatic GECs. However, the optimal treatment remains controversial, especially in infants. Here, we report a male infant case of GECs that successfully underwent minimally invasive combined neuroendoscopic cyst wall fenestration and cyst-peritoneal (CP) shunt.
The boy was delivered transvaginally at 38 weeks and 6 days of gestation with no neurological deficits. Magnetic resonance imaging (MRI) at birth revealed multiple cysts with smooth and rounded borders and a non-enhancing wall in the right parieto-occipital region. The size of the cyst had increased rapidly compared to that of the prenatal MRI, which was performed at 37 weeks and 2 days. On the day of birth, Ommaya cerebrospinal fluid (CSF) reservoir was placed into the largest outer cyst. The patient underwent intermittent CSF drainage; however, he experienced occasional vomiting. At 2 months, he underwent combined neuroendoscopic cyst wall fenestration and CP shunt through a small hole. The patient's postoperative course was uneventful and there was no recurrence of the cyst. The pathological diagnosis was GEC.
Combined neuroendoscopic cyst wall fenestration and CP shunt are a minimally invasive and effective treatment for infants with GECs.
室管膜下囊肿（GECs）是一种罕见的良性先天性颅内囊肿，占所有颅内囊肿的1%。有症状的GECs患者需要手术干预。然而，最佳治疗方法仍存在争议，尤其是在婴儿中。在此，我们报告一例成功接受微创联合神经内镜囊肿壁开窗术和囊肿 - 腹腔（CP）分流术的男性婴儿GECs病例。
该男婴在妊娠38周6天时经阴道分娩，无神经功能缺损。出生时的磁共振成像（MRI）显示右顶枕区有多个边界光滑圆润且壁无强化的囊肿。与在妊娠37周2天时进行的产前MRI相比，囊肿大小迅速增加。出生当天，将Ommaya脑脊液（CSF）储液囊置入最大的外侧囊肿。患者接受了间歇性脑脊液引流；然而，他偶尔会呕吐。2个月时，他通过一个小孔接受了联合神经内镜囊肿壁开窗术和CP分流术。患者术后恢复顺利，囊肿无复发。病理诊断为GEC。
联合神经内镜囊肿壁开窗术和CP分流术是治疗婴儿GECs的一种微创且有效的方法。
