摘要
本文报道了6例后颅凹包虫囊肿手术治疗,其中完整摘除囊肿5例,破溃摘除1例。我们使用脑室内加压与局部加压漂浮法相结合,可以使包虫囊肿缓慢脱出完整摘除。术中切开皮层分离外囊时需要特别仔细小心,动作轻柔、缓慢,以防将内囊弄破发生过敏性休克,使子囊随脑脊液种植到其它部位,形成多发生性包虫囊肿。
Since 1983 six patients with the hydatid cysts of the posterior fossa were adimitted to our hospital. Five of the patients were male and one was female. The age ranged from 6～42 years old, mean 14.4 years. The major complaints were headache and vomiting. Upon neurological examination, bilateral papilledemas and ataxia were revealed in all of the patients. Computed tomography scanning showed a round sharply defined low density cyst located within the cerebellar hemispheres or the vermis. There was no perifocal edema or rim enhancement after injection of contrast material. We feel that CT scanning has great vahie in both tomographic diagnosis and qualitative diagnosis of posterior fossa hydatid cysts. The main surgical management was to remove the cysts without rupture of them. During the operation a drainage tube was put into the posterior horn of the lateral ventricale of the brain to relieve the intracranial pressure before removing the cysts and to increase the intraventrical pressure so that the cysts could safely float out of the brain with Dowling's technique. In our opinion, a clear diagnosis should be obtained before operation and cerebrotomy should be carefully performed and simple needle aspiration of the cysts should be avoided in order to prevent the rupture of the cysts, which may cause anaphylactic shock or the protoscoleces spreading to other place of the brain, and forming the secondary hydatid cysts.
