Kaisho Y, Miyazaki S, Shimo-oku M, Hayashi T, Tani E
Department of Ophthalmology, Hyogo College of Medicine, Japan.
Nippon Ganka Gakkai Zasshi. 1995 Jan;99(1):109-14.
We followed a case of suprasellar arachnoid cyst for 12 years. The patient was a sixteen-year-old girl without particular problems in her general condition. She showed optic atrophy in both eyes and optic nerve hypoplasia with an inferotemporal quandranopsia in the left eye. A suprasellar arachnoid cyst communicating with the tubarachnoid space was found to extend into the sella turcica as an empty sella. A cyst wall was resected and a cyst-peritoneal shunt performed. After 12 years from the operation, sensitivity was slightly depressed in the visual field where it had already been disturbed. Although there are few reports in the literature on involvement of the optic nerves and chiasma by suprasellar arachnoid cysts, papilledema and optic atrophy are often found in children, and infero-temporal quandranopsia or homonymous hemianopsia have been reported. Visual field defects were most likely caused by compression of the optic nerve by cyst or prolonged papilledema. We also suspect that some kind of disturbance to the optic nerve occurred during extension of the arachnoid cyst as an empty sella, or during formation of arachnoid cyst in the fetus stage.
我们对一例鞍上蛛网膜囊肿患者进行了12年的随访。患者为一名16岁女孩，全身状况无特殊问题。她双眼出现视神经萎缩，伴有视神经发育不全，左眼有颞下象限盲。发现一个与蛛网膜下腔相通的鞍上蛛网膜囊肿延伸至蝶鞍，形成空蝶鞍。切除囊肿壁并进行囊肿 - 腹腔分流术。术后12年，视野中原本受影响的区域敏感度略有下降。虽然文献中关于鞍上蛛网膜囊肿累及视神经和视交叉的报道较少，但儿童中常出现视乳头水肿和视神经萎缩，且有报道称存在颞下象限盲或同向性偏盲。视野缺损很可能是由囊肿对视神经的压迫或长期视乳头水肿引起的。我们还怀疑在蛛网膜囊肿作为空蝶鞍扩展过程中，或者在胎儿期蛛网膜囊肿形成过程中，视神经受到了某种干扰。
