带蒂颞肌填塞治疗颅内巨大症状性蛛网膜囊肿(附6例报告)

目的 探讨颅内巨大症状性蛛网膜囊肿形成因素及治疗方法。方法 总结1998～2002年收治临床少见6例颅内巨大蛛网膜囊肿病因及采用带蒂颞肌填塞治疗的临床经验。结果 采用带蒂颞肌肌瓣填塞巨大颅内蛛网膜囊肿腔可发挥其强大的吸收作用，脑组织可逐渐膨胀，术后两周CT复查囊肿明显缩小，6～8月后复查囊肿消失，辅以抗癫痫药物应用，未见癫痫再发作。结论 由于外伤、炎症或手术后引起蛛网膜周围软脑膜粘连及较晚出现颅高压症状，病程长，确诊晚等综合因素是形成少见颅内巨大蛛网膜囊肿的主要原因。对病史中有间歇癫痫发作伴头部外伤、颅内炎症或颅脑手术史患者，应尽早做头颅CT检查，以排除IAC或明确IAC存存，避免颅内巨大IAC形成。采用带蒂颞肌填塞治疗．简便实用，安全可靠．效果满意，为治疗少见颅内巨大蛛网膜囊肿的较好方法．

Tamponade of pedicled temporalis muscle flap in the treatment of huge symptomatic intracranial arachnoid cyst:report of 6 cases

Objective To discuss the formations and treatment of huge symptomatie intracraniat arachnoid cyst (IAC). Methods 6 IAC cases admitted from 1998 to 2000 were retrospectively analyzed in the aspects of their formation and treatment with tamponade of pedicled temporalis muscle flap. Results Pedicled temporalis muscle flap had strong absorption in IAC. The brain tissues expanded gradually through CT examination and the cysts sharply shrank 2 weeks after operation and disappeared 6 to 8 months after operation. All cases had no recurrence of epilepsy in case of antiepileptic application. Conclusion IAC resulting from leptomeningeal conglutination formation around arachnoid after trauma, inflammation or surgical operation, delayed intracranial pressure, long course and delayed diagnosis. The patients who have intermittent epilepsy recurrence and the history of brain trauma, intracranial inflammation or brain operation need brain examination by CT as early as possible so as to identify ICA or suffocate the chance of IAC formation. The therapy was simple, safe and effective in treatment of IAC.