Stern J D, Ross D A
Section of Neurological Surgery, University of Michigan Medical Center, Ann Arbor.
Neurosurgery. 1993 Feb;32(2):310-4; discussion 314. doi: 10.1227/00006123-199302000-00024.
Recent case reports describing the open resection of symptomatic benign cysts of the pineal region have noted that the results of stereotactic management of such cysts have not been reported. We report the results of the stereotactic aspiration of benign pineal region cysts in two patients with symptomatic ventriculomegaly secondary to obstruction of the aqueduct. Stereotactic aspiration produced several cubic centimeters of brown-to-yellow fluid that was negative for tumor on cytological examination. Ventriculomegaly and symptoms were relieved without complications by the procedure in one patient who remains asymptomatic after 30 months of follow-up. In the second patient, persistent ventriculomegaly demonstrated on computed tomography resulted in the placement of a ventriculoperitoneal shunt; however, this was removed several months later during an episode of appendicitis and the patient remained asymptomatic without the shunt. The symptoms and ventriculomegaly recurred 71 months postaspiration, and the cyst was reaspirated. Ten months later, she remains asymptomatic. Options for managing such patients include open resection, shunting, and stereotactic aspiration. The relative merits of each approach are discussed.
近期有关松果体区有症状的良性囊肿开放性切除的病例报告指出，此类囊肿的立体定向治疗结果尚未见报道。我们报告了两例因导水管梗阻继发症状性脑室扩大的患者，对其松果体区良性囊肿进行立体定向抽吸的结果。立体定向抽吸抽出了数立方厘米棕黄色液体，细胞学检查未发现肿瘤细胞。在一名患者中，该操作缓解了脑室扩大及症状，且无并发症，随访30个月后仍无症状。在第二名患者中，计算机断层扫描显示脑室持续扩大，遂放置了脑室腹腔分流管；然而，几个月后在阑尾炎发作期间该分流管被移除，患者在没有分流管的情况下仍无症状。抽吸术后71个月，症状和脑室扩大复发，囊肿再次被抽吸。10个月后，她仍无症状。治疗此类患者的选择包括开放性切除、分流术和立体定向抽吸。本文讨论了每种方法的相对优点。
