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原发性颈静脉孔纤维发育不良:经硬膜外颞下经颈静脉入路的手术细节视频。病例展示

Primary jugular foramen fibrous dysplasia: surgically nuanced video of extradural infratemporal transjugular approach. Illustrative case.

作者信息

Eduardo da Silva Carlos, Clara Thibes Ana, Vidaletti Tamara

机构信息

Centro de Neurologia e Neurocirurgia - CNNc, Hospital Ernesto Dornelles, Porto Alegre, Rio Grande do Sul, Brazil.

Anatomy, DCBS, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil.

出版信息

J Neurosurg Case Lessons. 2024 Oct 14;8(16). doi: 10.3171/CASE24396.

Abstract

BACKGROUND

Fibrous dysplasia of the bone is a disease caused by a somatic GNAS mutation that affects craniofacial bones and can have a mass effect on different neurovascular structures. The authors present the first case of primary jugular foramen fibrous dysplasia with occlusion of the transverse and sigmoid sinuses.

OBJECTIVE

A 33-year-old man presented with a history of dizziness and occasional dysphagia over the past year. Magnetic resonance imaging showed a uniform enhanced mass in the left jugular foramen, with complete blockage of the adjacent transverse and sigmoid sinuses. The computed tomography scan revealed a cystic bone lesion of the jugular foramen. The patient underwent a gross-total removal of the tumor through an infratemporal transjugular approach with complete preservation of the lower cranial nerves.

LESSONS

This first reported case of primary jugular foramen fibrous dysplasia highlights the importance of considering this diagnosis when evaluating jugular fossa lesions. Understanding the anatomy of the infratemporal and jugular fossae, along with proficiency in microsurgical techniques, is essential for removing such tumors while preserving cranial nerve functions and the patient's quality of life. https://thejns.org/doi/10.3171/CASE24396.

摘要

背景

骨纤维发育不良是一种由体细胞GNAS突变引起的疾病,可累及颅面骨,并可对不同的神经血管结构产生占位效应。作者报告了首例伴有横窦和乙状窦闭塞的原发性颈静脉孔纤维发育不良病例。

目的

一名33岁男性,有过去一年头晕和偶尔吞咽困难的病史。磁共振成像显示左侧颈静脉孔有一个均匀强化的肿块,相邻的横窦和乙状窦完全阻塞。计算机断层扫描显示颈静脉孔有囊性骨病变。患者通过颞下经颈静脉入路接受了肿瘤全切术,同时完全保留了低位颅神经。

经验教训

首例报道的原发性颈静脉孔纤维发育不良病例强调了在评估颈静脉窝病变时考虑这一诊断的重要性。了解颞下窝和颈静脉窝的解剖结构,以及精通显微外科技术,对于在保留颅神经功能和患者生活质量的同时切除此类肿瘤至关重要。https://thejns.org/doi/10.3171/CASE24396。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b206/11488373/bc368b6f08c8/CASE24396_figure_1.jpg

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