四脑室囊虫病的诊断和治疗

目的 探讨四脑室囊虫病的诊断及治疗方法。方法 对我院2000年1月～2006年11月收治的15例四脑室囊虫病患者进行回顾性总结、分析。结果 CT扫描示脑积水、四脑室囊状扩张,4例可见囊虫头节;MRI矢状位T1加权像示四脑室内有一囊性病灶,10例可见囊虫头节。血清囊虫ELISA检查10例阳性。13例术后颅高压症状均立即解除,2例误诊为脑积水,摘除囊虫后症状消失,随访1.5年未见复发。结论 MRI是诊断四脑室囊虫病的首选影像学检查方法,血清囊虫ELISA检查简便,可协助诊断。枕下正中入路四脑室囊虫摘除术是有效的治疗方法。

Diagnosis and treatment of neurocysticercosis of the fourth ventricle

Objective To explore the diagnosis and treatment of neurocysticercosis of the fourth ventricle.Methods The clinical data of 15 patients suffered from neurocysticercosis of the fourth ventricle from January 2000 to November 2006 were analyzed retrospectively.Results Saccular dilatation of the fourth ventricle and obstructive hydrocephalus were shown on CT scan,and scolex could be well seen in 4 cases.Cystic lesions were shown on MRI in T1-weighted sagittal scanning,scolex could be seen on T1WI in 10 cases,serum ELISA test were positive in 10 patients,two cases misdiagnosised for hydrocephalus.The symptoms of intracranial hypertension were immediately relieved after craniotomy in all cases.Mean follow-up postsurgery for this series exceed 1.5 years.Conclusions MRI is the best choice for the diagnosis of the fourth ventricle cysticercosis.Serum ELISA test is proved to be convenient and highly coincidence with clinic.This experience indicates that direct excision by the suboccipital approach is an effective choice for fourth ventricle cystic lesions.