蛛网膜囊肿手术适应证

目的 探讨蛛网膜囊肿(IAC)患者的手术适应证。方法 2007年1月～2011年4月间收治的72例IAC患者均行颅脑CT检查，其中46例行CT蛛网膜下腔脑池造影(CTC)检查，观察其临床症状及分析影像学检查，应用统计学方法进行对比研究，并进行随访。结果 72例患者均经颅脑CT检查确诊为IAC，其中45例手术治疗，27例非手术治疗；46例行CTC检查显示：交通性蛛网膜囊肿(CIAC)13例，非交通性蛛网膜囊肿(NCIAC)33例。45例术后临床症状都得到一定程度的改善，无明显并发症，头痛症状及癫痫的发生率明显减少(P<0.05)，囊肿大小较术前明显缩小(P<0.01)。结论 颅脑CT平扫及CTC对于IAC的诊断及手术适应证选择有重要意义。IAC的绝对手术适应证为有明确临床症状的NCIAC，IAC的相对手术适应证为临床症状加重或复查CT囊肿增大的CIAC。

Surgical indication of intracranial arachnoid cyst

Objective To explore the surgical indication of intracranial arachnoid cyst. Methods 72 cases treated with ICA in our hospital from January 2007 to April 2011 were collected with CT scan, including 46 cases with CTC. Changes of symptoms and imaging were detected and compared by statistical methods. Follow-up of the patients was also carried out. Results All the cases were diagnosed for ICA by brain CT scan, including 45 cases with operation and 27 cases without operation. The CTC taken in 46 cases showed that 13 cases were communicating intracranial arachnoid cyst (CICA) and 33 cases were non-communicating intracranial arachnoid cyst (NCICA). After surgery, the clinical symptoms were improved by different degrees with no serious complications. The results of statistical analysis demonstrated that the preoperative incidence of headache and epilepsy decreased greatly than post-operation (P<0.05) and the cyst size was reduced significantly (P<0.01). Conclusion The CT scanning and computed tomographic cisternography are vital for the diagnosis of the intracranial arachnoid cysts and evaluation of the surgical indications. The absolute surgical indications of IAC patients include the noncommunicating intracranial arachnoid cyst with definite clinical symptoms; while the relative indications contain the communicating intracranial arachnoid cyst with progressing symptoms or increased cyst shown on CT scanning.