显微手术摘除第四脑室脑囊虫

目的　探讨利用小脑扁桃体延髓沟的显微解剖空间 ,在手术摘除第四脑室脑囊虫病中的应用价值。方法　采用后正中直切口 ,双侧枕下小骨窗开颅 ,利用小脑扁桃体延髓沟的显微解剖空间 ,在显微镜下 ,沿第四脑室正中孔向上 ,切开脉络膜 ,完整取出脑室内脑囊虫 ,共计 2 9例。结果　 2 9例第四脑室脑囊虫病灶均完整取出 ,未切开小脑蚓部。术后颅内压增高症状消失 ,平衡障碍均恢复 ,未出现小脑缄默症 ,无肌张力改变。结论　利用小脑扁桃体延髓沟的显微解剖空间 ,不必要切开小脑下蚓部 ,就可以完整取出第四脑室内脑囊虫病

Minimally invasive resection of the fourth ventricle cysticurcosis

Objective To study the application value of taking good use of the microanatomy of the cerebellomedullary fissure, during the minimally invasive resection of the fourth ventricle cysticurcosis.Methods Totally, 29 patients with the fourth ventride cysticurcosis were removed by posterior midline incision, small subocciptal bone window. Under the microscope, tela choroidea was opened, from the Magendie's foramen and the ventricle cysticurcosis was punctured and finally removed from the fourth ventricle smoothly.Results All 28 patients' ventricle cystcurcoses were resected without cutting the inferior vermis. Symptoms of intracranial hypertension disappeared. equilibratory disturbances disappeared gradually. No cerebellar mutism and hypotonia occurred postoperatively.Conclusion Taking good use of the microanatomy of the cerebellomedullary fissure, the fourth ventricle cysticurcosis can be removed without splitting the vermis.