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脑室内神经囊尾蚴病的外科治疗:经胼胝体间脑半球入路治疗2例

Surgical management of intraventricular neurocysticercosis: Two cases treated through transcallosal interhemispheric approach.

作者信息

Golden Nyoman, Tombeng Marthinson Andrew, Lauren Christopher

机构信息

Department of Surgery, Neurosurgery Division, Universitas Udayana, Prof. Dr. I Goesti Ngoerah Gde ( I.G.N.G ) Ngoerah General Hospital, Denpasar, Bali, Indonesia.

出版信息

Surg Neurol Int. 2024 Jun 7;15:193. doi: 10.25259/SNI_301_2024. eCollection 2024.

Abstract

BACKGROUND

Cysticercosis, caused by the larval stage of , is a prevalent parasitic infection affecting the central nervous system, primarily in low-income countries. Surgical intervention becomes necessary when cysticercosis manifests within the ventricular system, with endoscopic techniques increasingly preferred over traditional microsurgical methods due to lower risks and morbidity. However, the microsurgical transcallosal approach, although effective, is infrequently used due to its associated high morbidity.

CASE DESCRIPTION

We present two cases of multiple intraventricular neurocysticercosis treated through an open microsurgical technique using a transcallosal interhemispheric approach. Patient 1, a 56-year-old male, presented with severe headaches persisting for 6 months, while Patient 2, a 54-year-old male, experienced a sudden decrease in consciousness. Both patients exhibited typical magnetic resonance imaging characteristics indicative of intraventricular neurocysticercosis, leading to the decision for surgical resection.

CONCLUSION

Despite the transcallosal approach's decreased popularity due to associated risks, we achieved relatively good outcomes with minimal morbidity in both cases. Our experience highlights the importance of considering microsurgical approaches, particularly in facilities lacking endoscopic instrumentation, for the effective management of intraventricular neurocysticercosis. Compliance with postoperative medical therapy remains crucial to prevent recurrence.

摘要

背景

囊尾蚴病由猪带绦虫幼虫阶段引起,是一种主要在低收入国家流行的影响中枢神经系统的寄生虫感染。当囊尾蚴病出现在脑室系统时,手术干预就变得必要,由于风险和发病率较低,内镜技术比传统显微手术方法越来越受到青睐。然而,显微手术经胼胝体入路虽然有效,但因其相关的高发病率而很少使用。

病例描述

我们报告两例通过经胼胝体半球间入路的开放性显微手术技术治疗的多发性脑室内囊尾蚴病病例。病例1是一名56岁男性,出现严重头痛持续6个月,病例2是一名54岁男性,意识突然下降。两名患者均表现出典型的磁共振成像特征,提示脑室内囊尾蚴病,因此决定进行手术切除。

结论

尽管经胼胝体入路因相关风险而不太受欢迎,但我们在两例病例中均取得了相对较好的结果,发病率极低。我们的经验强调了在缺乏内镜设备的情况下,考虑显微手术方法对于有效治疗脑室内囊尾蚴病的重要性。术后坚持药物治疗对于预防复发仍然至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ff/11225520/ea01620a108c/SNI-15-193-g001.jpg

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