微侵袭神经外科技术治疗脑猪囊虫病

Minimally invasive neurosurgery for neurocysticercosis

目的 探讨脑猪囊虫病的临床、病理特征及外科处理的适应证 ,介绍采用 CT脑立体定向、神经导航结合显微手术等微侵袭神经外科技术治疗脑猪囊虫病的经验与体会 .方法 脑猪囊虫病患者 382例 ,采用 CT脑立体定向技术定位 376例 ,神经导航技术定位 6例 ,行“钥匙孔”小范围开颅 ,在显微镜下切除所有病灶 .结果 30 9例有癫痫症状者 ,术后30 3例症状消失 ,6例症状减轻 ,需继续给予抗癫痫药物治疗 ,术前有偏瘫 5 1例 ,失语 2 3例患者 ,均于术后 1mo内完全恢复 ,未出现新的神经损害症状 ,无并发症及死亡 .结论 微侵袭神经外科技术是一种安全可靠、创伤很小的方法 ,用于治疗脑猪囊虫病可取得满意疗效 .

AIM To investigate the clinical and pathological features, surgical indications of neurocysticercosis, and to report the experience of some minimally invasive neurosurgery techniques (stereotactic operation, neuronavigation, and microneurosurgery) for the treatment of neurocysticercosis. METHODS Three hundred and eighty two patients with neurocysticercosis were reported. CT and MRI scans showed enhanced small lesion in cerebrum surrounded by edema. Of 382 cases, 376 underwent CT guided stereotatic microneurosurgery, the others underwent neuronavigator operation. RESULTS For the 309 patients with seizures, 303 were cured, 6 were improved. The hemiplegia (51 cases) and aphasia (23 cases) were recovered in one month. None of the patients had complications after operation, and there was no mortality. CONCLUSION The mininally invasive neurosurgery technique is a very safe and effective mothod for the treatment of neurocysticercosis.