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巨大枕部脑膨出:一例报告及文献复习

Giant Occipital Encephalocele: A Case Report and Literature Review.

作者信息

Hussen Endris, Gebremedhin Feleke Woldemichael

机构信息

Department of Neurosurgery, St. Paul's Millennium Medical College, Addis Ababa, Ethiopia.

Addis Ababa University College of Medicine and Health Sciences Hospital-Currently Practicing at St. Peter's Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.

出版信息

Int Med Case Rep J. 2023 Sep 12;16:529-535. doi: 10.2147/IMCRJ.S433167. eCollection 2023.

Abstract

BACKGROUND

Protrusion of cerebrospinal fluid and meninges is called meningocele. Meningoencephalocele is a protrusion of neural tissue and meninges. The incidence of an Encephalocele is 1 in every 5000 live births. Anterior encephalocele is more common in men, while occipital encephalocele is seen in 70% of women. In a large encephalocele, the head size is small. Encephaloceles can occasionally be very large and are called giant encephaloceles. Occipital encephaloceles accounted for 80% to 90% of encephalocele cases in the western hemisphere. Encephaloceles vary in size and content. Various factors affecting the prognosis of patients with occipital encephalocele. Among them: extent, amount of brain tissue in the sac with or without Dural venous sinuses in the sac, with the brain or occipital lobe with hydrocephalus or presence of ventricles. Rarely, the sagittal and transverse sinuses are adjacent to the sac.

CASE PRESENTATION

This is a case of an 8-month old male infant born to a mother who had no regular antenatal care. After the baby presented with progressively increasing posterior head mass which is cystic, transilluminating, tender and size is 40cmX35cm imaging demonstrated small brain tissue mainly part of right occipital lobe with most of the sac being occupied by cerebrospinal fluid. Repair done and dysplastic brain tissue resected then healthy-looking brain tissue and Dural sinuses reduced to the skull, then patient stayed in the hospital and closely followed for hydrocephalus for seven days and discharged with no hydrocephalus and no neurologic deficit.

摘要

背景

脑脊液和脑膜的突出称为脑膜膨出。脑膜脑膨出是神经组织和脑膜的突出。脑膨出的发病率为每5000例活产中有1例。前脑膨出在男性中更常见,而枕部脑膨出在70%的女性中可见。在巨大脑膨出中,头部尺寸较小。脑膨出偶尔会非常大,被称为巨大脑膨出。在西半球,枕部脑膨出占脑膨出病例的80%至90%。脑膨出的大小和内容物各不相同。多种因素影响枕部脑膨出患者的预后。其中包括:范围、囊内脑组织的数量、囊内有无硬脑膜静脉窦、有无脑积水或脑室的脑或枕叶。很少见的是,矢状窦和横窦与囊相邻。

病例介绍

这是一例8个月大的男婴,其母亲没有定期进行产前检查。婴儿出现后头部逐渐增大的肿块,呈囊性、透光、压痛,大小为40cm×35cm,影像学检查显示主要为右枕叶的小部分脑组织,囊的大部分被脑脊液占据。进行了修复手术,切除了发育异常的脑组织,然后将外观健康的脑组织和硬脑膜窦还纳至颅骨,患者住院观察脑积水情况7天,出院时无脑积水且无神经功能缺损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c2f/10505012/31f427960426/IMCRJ-16-529-g0001.jpg

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