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被困颞角:从理论到实践,对当前认识与未来展望的系统综述

Trapped temporal horn: From theory to practice, a systematic review of current understanding and future perspectives.

作者信息

Ashir Shafique Muhammad, Saqlain Mustafa Muhammad, Haseeb Abdul, Mussarat Abdullah, Arham Siddiq Muhammad, Faheem Iqbal Muhammad, Iqbal Javed, Kuruba Venkataramana, Patel Tirath

机构信息

Department of Neurosurgery, Jinnah Sindh Medical University, Karachi, Pakistan.

Department of Neurosurgery, Dow University of Health Science, Karachi, Pakistan.

出版信息

World Neurosurg X. 2024 Mar 7;23:100345. doi: 10.1016/j.wnsx.2024.100345. eCollection 2024 Jul.

Abstract

BACKGROUND

The Entrapped Temporal Horn (ETH) is characterized by localized enlargement of the temporal horn of the lateral ventricle of the brain. This study aimed to investigate the factors, development, prognosis, and effective treatment.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search was conducted in major research databases. The inclusion criteria included patients of all ages with TTH diagnosis in cohort studies, case series, and case reports.

RESULTS

Our study included 160 patients and 49 studies. The major causes of TTH were neoplastic lesions (42.3%), infections (22.3%), and cystic disease (13.08%). Of these cases, 71 were unrelated to cranial surgery, while 89 were unrelated to prior surgeries. Headache was the most common symptom (41.91%), followed by seizures (13.20%), drowsiness (12.50%) and memory loss (11.00%). Surgery was not required in 17 patients. Fenestration of the trapped temporal horn was performed in 24 patients, while VP/VA shunt surgeries were performed in the majority (57 patients) owing to favorable outcomes, lower revision rates, and extensive experience. However, TTH recurred in six of the 21 patients who underwent endoscopic ventriculocisternostomy. Tumors were the main cause, and isolated headache was the most frequent symptom. Ventriculoperitoneal shunts (VPS) are preferred because of their positive outcomes, lower revision rates, and wider expertise. Tumors near the trigonal area pose a higher risk.

CONCLUSION

Although TTH remains a rare condition, VPS continues to be the most widely preferred procedure among surgeons.

摘要

背景

颞角受压(ETH)的特征是脑侧脑室颞角局部扩大。本研究旨在探讨其相关因素、发展过程、预后及有效治疗方法。

方法

按照系统评价与Meta分析的首选报告项目(PRISMA)指南,在主要研究数据库中进行了系统检索。纳入标准包括队列研究、病例系列和病例报告中所有年龄确诊为TTH的患者。

结果

我们的研究纳入了160例患者和49项研究。TTH的主要病因是肿瘤性病变(42.3%)、感染(22.3%)和囊性疾病(13.08%)。其中,71例与颅脑手术无关,89例与既往手术无关。头痛是最常见的症状(41.91%),其次是癫痫发作(13.20%)、嗜睡(12.50%)和记忆力减退(11.00%)。17例患者无需手术。24例患者进行了受压颞角开窗术,而由于效果良好、翻修率低且经验丰富,大多数患者(57例)进行了脑室腹腔分流术(VP/VA)。然而,在接受内镜下脑室脑池造瘘术的21例患者中,有6例TTH复发。肿瘤是主要原因,孤立性头痛是最常见的症状。由于脑室腹腔分流术(VPS)效果良好、翻修率低且专业知识广泛,因此更受青睐。三角区附近的肿瘤风险较高。

结论

尽管TTH仍然是一种罕见疾病,但VPS仍然是外科医生中最广泛首选的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09a3/10950730/b898c469b40e/gr1.jpg

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