透明隔囊肿的神经内镜手术治疗

目的探讨有症状的透明隔囊肿的神经内镜手术治疗方法及应用价值.方法采用德国产Storz外径4.0mm神经内镜经纵裂入路及经额角入路行囊肿-侧脑室造瘘术治疗有症状的透明隔囊肿12例,头痛、癫痫及精神症状为主要临床表现,其中2例合并脑积水.结果12例术后症状均改善,其中以颅高压症为主要表现者6例中,4例症状完全消失,2例减轻,4例癫痫发作者未再发作.12例随访6个月～2年,平均18个月,复查CT或MRI囊肿缩小＜50%7例,50%～90%3例,＞90%2例.2例脑积水均消失.结论对透明隔囊肿应用神经内镜行囊肿-侧脑室造瘘术微创、安全、有效.

Endoscopic neurosurgery for the treatment of septum pellucidum cysts

Objective To discuss the techniques and significance of neuroendoscopic treatment for symptomatic septum pellucidum cysts. Methods A total of 12 patients with symptomatic septum pellucidum cysts were given a cyst-lateral ventricle ventriculostomy via a transcallosal and transventricular approach by using a neuroendoscope 4.0 mm in external diameter(Storz,Germany).Headache,epilepsy,and mental symptoms were prominent clinical manifestations.Two patients were complicated with hydrocephalus. Results Improvement of symptoms was achieved postoperatively in all the 12 patients.Out of 6 patients with a major sign of intracranial hypertension,symptoms completely disappeared in 4 patients and improved in 2 patients.Four patients with epilepsy attacks had no recurrence.A follow-up was made in 12 patients for 6~24 months(mean,18 months).Re-examinations of CT or MRI showed the cysts had decreased in size by <50% in 7 patients,by 50%~90% in 3 patients,and by >90% in 2 patients.The lesions completely disappeared in 2 patients with hydrocephalus. Conclusions Neuroendoscopic cyst-lateral ventricle ventriculostomy for septum pellucidum cysts is a safe,effective,and minimally invasive operation.