高颅压型脑囊虫病的综合治疗

Combined treatment of neurocysticercosis with elevated intracranial pressure

目的探讨高颅压型脑囊虫病的手术与药物治疗。方法采用回顾性研究方法对33例高颅压型脑囊虫病的临床表现、影像资料及手术方法和药物治疗进行分析。结果高颅压型脑囊虫病表现为颅内压进行性增高,依临床表现及CT、MRI检查大部分可早期诊断,但对部分不典型者常易误诊,MRI检查有助于鉴别诊断,对有明显占位或脑脊液循环梗阻者,应手术摘除囊虫;对经药物治疗后出现颅内压升高并危及生命者应行颞肌下减压。术后均应配合药物治疗。结论高颅压型脑囊虫病依其临床表现、影像资料多可早期诊断,其治疗应是手术治疗结合合理的药物治疗。

【Objective】 To study the treatment of neurocysticercosis with surgical and antihelmintie medical therapy. 【Methods】 The clinical manifestations, images of CT or MRI and methods of surgical and antihelmintie medical therapy in 33 cases of neuroeysticercorsis with elevated intraeranial pressure were analyzed retrospectively. 【Results】 Their clinical manifestations were gradually elevated intracranial pressure. Most of the cases could be early diagnosed depending on clinical manifestations and images of CT or MRI. Those who have no particular clinical manifestations always were misdiagnosed, MRI could help to detect. To those eases with massive lesions or destructing of CSF pathway, removal of the cysts should be considered. To those easas with elevated intraeranial pressure after antihelmintie medical therapy or life-threatening hydrocephalus, decompression procedures may be necessary. All the eases should give antihelmintic medical treatment after surgical extirpation. 【Conclusions】 Neurocysticercosis with elevated intracranial pressure could be early diagnosed depending on clinieal manifestations and MRI or CT. Both medical and surgieal interventions may be necessary for adequate treatment.