Vinchon M, Lejeune J P, Krivosic I, Assaker R, Pruvo J P, Christiaens J L
Service de Neurochirurgie, Hôpital B, Lille.
Neurochirurgie. 1995;41(1):29-37.
The pathogenesis of cranial dermoids and epidermoids is still controversial, owing to the multiple etiologies and locations of these lesions. We reviewed 25 cases, classified as follows: extradural lesion of the calvarium; of the occipital squama; dysraphic occipital lesions; and strictly intradural lesions. In the latter group, all lesions but one were in a paramedian, prenevraxial situation, and could be classified according to their situation relative to the tentorium cerebelli. In our series, strictly intradural dermoids are more often in a rostral situation, and epidermoids in a more caudal situation. Dermoids appear earlier in life than epidermoids, suggesting a more rapid growth due to eccrine secretion. For each group of lesions, the pathogenic hypotheses are studied. Inclusion of epidermal nests at different levels might result from traumatism, dysraphism, or developmental trouble in the lamination of the different layers of the meninges. Most intradural lesions trent to be related to the formation of Rathke's pouch and closure of the anterior neuropore.
由于颅骨皮样囊肿和表皮样囊肿的病因和位置多样，其发病机制仍存在争议。我们回顾了25例病例，分类如下：颅骨硬膜外病变；枕骨鳞部病变；枕部神经管闭合不全病变；以及严格意义上的硬膜内病变。在后一组中，除1例外，所有病变均位于中线旁、脑神经根前，可根据其相对于小脑幕的位置进行分类。在我们的系列病例中，严格意义上的硬膜内皮样囊肿多位于较靠前的位置，而表皮样囊肿多位于较靠后的位置。皮样囊肿比表皮样囊肿在生命早期出现，提示由于汗腺分泌导致其生长更快。针对每组病变，研究了其致病假说。不同层次的表皮巢包埋可能是由于创伤、神经管闭合不全或脑膜各层分层过程中的发育问题所致。大多数硬膜内病变往往与拉克囊的形成和前神经孔的闭合有关。
