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第四脑室囊虫的内镜治疗(附二例报告)
引用本文:肖庆,陈国强,郑佳平,梁晖,黄乙洋,左焕琮.第四脑室囊虫的内镜治疗(附二例报告)[J].中华神经外科杂志,2010,26(12).
作者姓名:肖庆  陈国强  郑佳平  梁晖  黄乙洋  左焕琮
作者单位:1. 清华大学玉泉医院神经外科,北京,100049
2. 清华大学生命科学与医学研究院脑神经疾病研究所
摘    要:目的 探讨电子神经内镜手术治疗第四脑室囊虫的价值.方法 应用电子神经内镜对2例第四脑室内囊虫经中脑导水管进行手术摘除.其中1例术前MRI检查提示第四脑室内囊性病变;另1例术前检查提示病变位于第三脑室内,术中脑室探查时发现病变已经进入第四脑室.结果 2例第四脑室内囊虫均在神经内镜下完整摘除,术后患者无任何不良反应,脑脊液电影检查枕骨大孔区脑脊液流动良好.结论 应用电子神经内镜能够方便地对脑室系统进行全面探查,神经内镜手术摘除第四脑室内囊虫创伤小,并发症少,住院时间短,费用低,应作为第四脑室囊虫的首选治疗.

关 键 词:囊虫  第四脑室  电子神经内镜  梗阻性脑积水

Electrical flexible neuroendoscopic management of fourth ventricular cysticercosis:2 cases report
XIAO Qing,CHEN Guo-qiang,ZHENG Jia-ping,LIANG Hui,HUANG Yi-yang,ZUO Huan-cong.Electrical flexible neuroendoscopic management of fourth ventricular cysticercosis:2 cases report[J].Chinese Journal of Neurosurgery,2010,26(12).
Authors:XIAO Qing  CHEN Guo-qiang  ZHENG Jia-ping  LIANG Hui  HUANG Yi-yang  ZUO Huan-cong
Abstract:Objective To investigate the value of electrical flexible neuroendoscopic management of the fourth ventricular cysticercosis.Methods 2 cases of fourth ventricular cysticercosis were transaqueductally removed with an electrical flexible neuroendoscope.In one case,the preoperative MRI showed a cystic lesion in the fourth ventricle.In another case,the preoperative MRI showed the cystic lesion in the third ventricle,but during the course of exploration of ventricles under neuroeodoscope,the lesion was found to have migrated into the fourth ventricle.Results Complete excision of cysts in the fourth ventricle was performed in both patients with no significant operative or postoperative complications.Satisfactory postoperative CSF flow around foramen magnum was detected by cine phase-contrast magnetic resonance imaging.Conclusions The whole ventricular system can be explored easily with electrical flexible neuroendoscope.Electrical flexible neuroendoscopic management of the fourth ventricular cysticercosis should be the optimal choice due to its minimal invasion,less complications,shorter length of stay and cheaper treatment costs.
Keywords:Cysticercosis  The fourth ventricle  Electrical flexible neuroendoscopy  Obstructive hydrocephalus
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