神经内镜治疗脑室内蛛网膜囊肿

目的探讨神经内镜手术治疗脑室内蛛网膜囊肿的疗效。方法 2008年3月～2010年3月应用外径4mm0°硬性脑室镜(德国Rodolf公司)治疗20例脑室内蛛网膜囊肿,其中侧脑室16例,三脑室4例,术中根据囊肿的部位、囊肿与脑室壁的粘连情况、室间孔及中脑导水管是否闭锁分别施行囊肿切除、囊肿造瘘、囊肿造瘘+透明隔造瘘或三脑室底造瘘术。结果内镜下脑室囊肿造瘘术12例,其中2例室间孔闭锁同时行透明隔造瘘,4例中脑导水管梗阻同时行三脑室底造瘘术;内镜下囊肿切除8例,其中次全切除3例,部分切除5例。术后无出血、感染及神经功能缺失等并发症。20例随访3～6个月,平均5个月,20例术后症状均改善。结论神经内镜手术治疗脑室内蛛网膜囊肿具有操作简单、创伤小、术后恢复较快、疗效较好等优点。

Neuroendoscopy for the Treatment of Intraventricular Arachnoid Cysts

Objective To evaluate the efficacy of neuroendoscopy in the treatment of intraventricular arachnoid cysts.Methods A review of 20 patients with intraventricular arachnoid cysts,including 16 patients with lateral ventricular arachnoid cysts and 4 patients with third ventricular arachnoid cysts that were treated by neuroendoscopy from March 2008 to March 2010.Surgical methods were chosen according to the location of the cyst,severity of the adhesion between the cyst and the ventricular wall,and patency of the interventricular foramen and cerebral aqueduct.Results Endoscopic ventriculocystostomy was performed in 12 cases,in which,septumostomy was carried out simultaneously because of interventricular foramen atresia in 2 cases,and third ventrieulostomy were performed due to aqueductal obstruction in 4 cases.Endoscopic cystectomy was performed in 8 cases,including subtotal removal in 3 and partial removal in 5.After the procedures,no hemorrhage,infection or neurological deficiency occurred.The 20 patients were followed up for 3 to 6 months with a mean of 5 months,during the period,symptoms improvement was observed in all the cases.Conclusion Neuroendoscopy is a useful approach for intraventricular arachnoid cysts with minimal invasion,safety,as well as less complication and quick recovery.