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儿童四叠体板脂肪瘤伴癫痫和脑积水——一例报告

Quadrigeminal plate lipoma presenting with seizures and hydrocephalus in a child - A case report.

作者信息

Fagundes Walter, Correia Mariana Das Chagas, Dantas Sergio Fernandes, Petry Iago Nathan Simon

机构信息

Department of Neurosurgery, Federal University of Espirito Santo, Vitoria, Brazil.

Deparment of Medicine, Medical School of Multivix Vitória, Vitoria, Brazil.

出版信息

Surg Neurol Int. 2024 Nov 1;15:393. doi: 10.25259/SNI_728_2024. eCollection 2024.

Abstract

BACKGROUND

Intracranial lipomas are rare, benign lesions with no neoplastic origin. Most affected patients are asymptomatic and are typically pediatric or young adults. We describe a case of a child with a quadrigeminal plate lipoma presenting with seizures and hydrocephalus.

CASE DESCRIPTION

A 6-year-old boy presented with dysarthria, spasticity, gait disturbances, headaches, and seizures. Magnetic resonance imaging revealed a lipomatous lesion in the quadrigeminal cistern with ventriculomegaly. An endoscopic third ventriculocisternostomy was performed for obstructive hydrocephalus, and a biopsy confirmed a lipoma. Over 6 years of follow-up, the patient's seizures remained controlled, and the lesion remained stable.

CONCLUSION

Conservative management with symptomatic control is recommended, given the typically benign progression of lipomas. Seizures are generally well managed with antiepileptic medications. Surgical resection should be reserved for cases where expansive lesions cause significant symptoms or hydrocephalus.

摘要

背景

颅内脂肪瘤是罕见的良性病变,无肿瘤起源。大多数受影响的患者无症状,通常为儿童或年轻成年人。我们描述了一例患有四叠体板脂肪瘤的儿童,表现为癫痫发作和脑积水。

病例描述

一名6岁男孩出现构音障碍、痉挛、步态障碍、头痛和癫痫发作。磁共振成像显示四叠体池有脂肪瘤样病变并伴有脑室扩大。因梗阻性脑积水进行了内镜下第三脑室造瘘术,活检证实为脂肪瘤。经过6年的随访,患者的癫痫发作得到控制,病变保持稳定。

结论

鉴于脂肪瘤通常为良性进展,建议采用对症控制的保守治疗。癫痫发作一般用抗癫痫药物能得到很好的控制。对于占位性病变引起明显症状或脑积水的病例,应考虑手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a04/11618648/697c29e6c7d0/SNI-15-393-g001.jpg

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