Hernandez Lucas Miguel, Chisvo Nathan, Chan Abigail, O'Neill Kevin, Anichini Giulio
Department of Brain Sciences, Imperial College of London, London, United Kingdom.
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Surg Neurol Int. 2024 Nov 15;15:419. doi: 10.25259/SNI_529_2024. eCollection 2024.
Neuroepithelial cysts (NECs) are rare entities, occasionally causing neurological symptoms that can be overlooked.
A case of an occipital neuroepithelial cyst is discussed. The initial presentation consisted of mild homonymous hemianopia and gait impairment. Conservative management was suggested to start with, but at 6 months follow-up, the patient's symptoms were worsening. Surgery was performed under general anesthetic and using visual-evoked potentials. The cyst was marsupialized and connected with subdural space, and a few samples were sent for histological analysis. The patient experienced immediate improvement in her symptoms, and the visual tests at follow-up confirmed the resolution of the previously documented hemianopia.
NECs should be carefully assessed to rule out symptoms associated with mass effects. This case and others reported in the international literature show that occipital neuroepithelial cysts can benefit from surgical treatment with meticulous preoperative planning. The aid of neuromonitoring is crucial to identify anatomical variations and cortical functionality that are potentially distorted in the presence of these lesions.
神经上皮囊肿（NECs）较为罕见，偶尔会引发可能被忽视的神经症状。
讨论了一例枕叶神经上皮囊肿病例。最初的表现为轻度同向性偏盲和步态障碍。起初建议采取保守治疗，但在6个月的随访中，患者症状恶化。在全身麻醉下并使用视觉诱发电位进行了手术。囊肿被袋形缝合并与硬膜下腔相连，取了一些样本进行组织学分析。患者症状立即改善，随访时的视力测试证实先前记录的偏盲已消失。
应仔细评估NECs以排除与占位效应相关的症状。该病例及国际文献中报道的其他病例表明，枕叶神经上皮囊肿可受益于精心的术前规划下的手术治疗。神经监测对于识别这些病变存在时可能扭曲的解剖变异和皮质功能至关重要。
