24例颅内蛛网膜囊肿诊断与治疗

Diagnosis and treatment of 24 cases intracranial arachnoid cysts

目的： 报告２４ 例颅内蛛网膜囊肿（ＩＡＣ） 的诊断和治疗情况。方法： 对本科１９９３ 年１０ 月１９９８ 年１０ 月收治的ＩＡＣ 进行回顾性总结。结果：２４ 例患者以临床症状和体征结合ＣＴ 及ＭＲＩ 检查， 以及病理检查来确诊， 符合ＩＡＣ 的诊断； 治疗以手术治疗为主， 大部分病例行囊肿壁部分切除术加囊腔与脑池蛛网膜下腔交通术， 术后症状和体征均有显著改善， ＣＴ复查和随访证实治疗有效。结论：ＩＡＣ 临床表现由于其发生部位不同而表现不同的特点， 其好发部位最多见于枕大池和中颅窝外侧颞部； ＣＴ 及ＭＲＩ检查是ＩＡＣ 诊断最主要和最可靠的方法； 认为凡囊肿伴有颅内压增高， 引起神经系统器质性或功能性损伤者均应手术； 情况允许应尽可能切除囊壁， 建立囊腔与邻近脑池。

Objective: To report diagnosis and treatment of 24 cases intracranial arachnoid cysts (IAC). Methods:24 cases IAC were reviewed from 1993.oct to 1998.oct. Results: 24 cases IAC were diagnosised by clinical manifestation, CT or MRI examination and pathology. Principal treatment is surgical managements, in which most cases were cysts skin part resection and cysts cavity was transfered with brain ventricle and subarachnoid cavity. The effect was testified by CT or MRI reexamination and following up. Conclusion: Clinical symptom of IAC was different according to different site of cysts. The occipital big cavity and extra temporal lobe of middle fissa is predilection site. The CT and MRI examination is principal and reliable method on diagnosis of IAC. The patients with cysts that have conducted intracranial hyperpressure and substantial or functional lesion should be operated. If condition permited, skin of cysts should be all resected. It is key of operative success to establish transfer cysts cavity with nearby brain and subarachnoid cavity or brain ventricle.