Kumarasamy Sivaraman, Sharma Rajeev, Verma Satish Kumar, Singh Pankaj Kumar, Gupta Deepak Kumar, Suri Ashish, Kale Shashank Sharad
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurosurgery, Indraprastha Apollo Hospital, New Delhi, India.
Neurosurg Rev. 2025 Sep 17;48(1):645. doi: 10.1007/s10143-025-03770-0.
Bobble-head doll syndrome (BHDS) is a rare movement disorder characterized by continuous or periodic head movements. The head nodding or bobbing occurs either forward and backward (yes-yes) or side-to-side movement (no-no) direction at a 2-3 Hz frequency. It is due to lesions in and around the third ventricle, causing pressure on periventricular neuronal structures (thalami). The most common lesions are suprasellar arachnoid cysts. We intend to analyze the clinical presentation, imaging findings, treatment options, and surgical outcome of BHDS in suprasellar arachnoid cysts.
We retrospectively reviewed our database for BHDS in suprasellar arachnoid cysts surgically treated between 2016-2023. Patient records were reviewed with special attention to patient demographics, presentation, imaging findings, site and extent, surgery performed, complications, and outcomes.
A total of 5 patients with a mean age of 6.7 years were included in the study. Abnormal head movements were the most common presenting complaint. The mean duration of symptoms was 2.9 ± 2 years. All patients underwent cyst fenestration (endoscopic or microscopic assisted). Approaches used: craniotomy and microscopic-assisted cyst fenestration in 1 patient (20%) and endoscopic-assisted cyst fenestration in 4 patients (80%). One patient had partial resolution of symptoms at 6 weeks' follow-up. The remaining four patients (80%) had complete resolution of symptoms at 3-month follow-up.
BHDS is a rare movement disorder caused by lesions in and around the third ventricle. Neuroimaging can help in diagnosing this lesion. The most common clinical presentations are involuntary head movements related to the dilatation of the third ventricle and obstructive hydrocephalus. It is a surgical condition with a favourable outcome. Various treatment options are described in the literature. Endoscopic fenestration is the optimal and most commonly performed treatment option. The excellent outcome in BHDS with suprasellar arachnoid cysts can be achieved using endoscopic fenestration.
点头娃娃综合征（BHDS）是一种罕见的运动障碍，其特征为头部持续或周期性运动。头部点头或摆动以2-3赫兹的频率向前和向后（是-是）或左右方向（否-否）发生。它是由于第三脑室及其周围的病变，导致对脑室周围神经结构（丘脑）产生压力。最常见的病变是鞍上蛛网膜囊肿。我们旨在分析鞍上蛛网膜囊肿所致BHDS的临床表现、影像学表现、治疗选择及手术结果。
我们回顾性分析了2016年至2023年间接受手术治疗的鞍上蛛网膜囊肿所致BHDS的数据库。对患者记录进行了审查，特别关注患者人口统计学、临床表现、影像学表现、部位和范围以及所进行的手术、并发症和结果。
本研究共纳入5例平均年龄为6.7岁的患者。异常头部运动是最常见的就诊主诉。症状的平均持续时间为2.9±2年。所有患者均接受了囊肿开窗术（内镜或显微镜辅助）。采用的手术入路：1例患者（20%）采用开颅和显微镜辅助囊肿开窗术，4例患者（80%）采用内镜辅助囊肿开窗术。1例患者在6周随访时症状部分缓解。其余4例患者（80%）在3个月随访时症状完全缓解。
BHDS是一种由第三脑室及其周围病变引起的罕见运动障碍。神经影像学有助于诊断该病变。最常见的临床表现是与第三脑室扩张和梗阻性脑积水相关的不自主头部运动。这是一种手术治疗效果良好的疾病。文献中描述了各种治疗选择。内镜开窗术是最佳且最常用的治疗选择。采用内镜开窗术可在鞍上蛛网膜囊肿所致BHDS中取得良好疗效。
