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脊髓空洞症硬膜下病变及枕大孔和Magendie孔疏通术治疗效果的初步观察 被引量:6
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作者 关健 袁澄华 +7 位作者 刘振磊 王凯 段婉茹 王兴文 王作伟 吴浩 陈赞 菅凤增 《中华神经外科杂志》 CSCD 北大核心 2021年第7期694-699,共6页
目的:初步观察脊髓空洞症(SM)硬膜下的病变及枕大孔和Magendie孔疏通术(FMMD)治疗SM的疗效。方法:回顾性分析2018年7月至2019年1月首都医科大学宣武医院神经外科收治的50例SM患者的临床资料。总结术中所见硬膜下病变及可能引起脑脊液循... 目的:初步观察脊髓空洞症(SM)硬膜下的病变及枕大孔和Magendie孔疏通术(FMMD)治疗SM的疗效。方法:回顾性分析2018年7月至2019年1月首都医科大学宣武医院神经外科收治的50例SM患者的临床资料。总结术中所见硬膜下病变及可能引起脑脊液循环梗阻的因素,应用FMMD解除梗阻。观察术后并发症,评估手术安全性。术后3、6、12个月进行门诊随访,随访改良日本骨科协会(mJOA)颈椎评分,根据Tator评分标准评估临床疗效,并复查颅颈交界区MRI评估脊髓空洞。比较患者手术前、后的mJOA颈椎评分。结果:术中观察发现,50例患者中,下疝的小脑扁桃体占据枕大孔及覆盖Magendie孔44例(88%),两侧扁桃体间粘连18例(36%),扁桃体与脑干间粘连9例(18%),扁桃体发育不对称越过中线35例(70%),小脑后下动脉分支走行于Magendie孔11例(22%),Magendie孔表面假膜或瘢痕8例(16%),枕大池囊肿2例(4%),扁桃体与硬膜间粘连4例(8%)。50例患者中,仅1例(2%)术后出现颅内感染,其他患者术后未见明显并发症。50例患者的随访时间为(13.3±0.9)个月(12~15个月)。至末次随访,50例患者复查MRI结果显示,脊髓空洞好转44例(88%)、稳定6例(12%);临床疗效好转44例(88%),稳定4例(8%),恶化2例(4%);mJOA颈椎评分较术前提高[分别为(14.7±3.2)分和(12.9±3.1)分,配对t=2.83,P=0.03]。结论:SM患者硬膜下存在多种病变,经FMMD治疗后,患者的症状和影像学表现均明显改善,且手术相关并发症少。 展开更多
关键词 脊髓空洞症 ARNOLD-CHIARI畸形 病理学 治疗结果 枕大孔和magendie孔疏通术
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A case of congenital obstruction of magendie's foramen:embryologic analysis and treatment
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作者 HA N'da S Fondjo +2 位作者 LK Drogba LM Konan V Ba Zeze 《Chinese Neurosurgical Journal》 CSCD 2017年第4期243-246,共4页
Background: Fourth ventricle isolated Magendie's foramen primitive obstruction is rare. The etiology and the pathophysiology of the constitution of this obstruction in congenital cases remain elusive. We report a ... Background: Fourth ventricle isolated Magendie's foramen primitive obstruction is rare. The etiology and the pathophysiology of the constitution of this obstruction in congenital cases remain elusive. We report a case of congenital obstruction of Magendie's foramen in an adult patient and discuss the embryogenic mechanism and our management of this rare pathology.Case presentation: A 20 years old female patient without any medical history was referred for headaches and vomiting. Emergency CT scan revealed major hydrocephalus subsequently she underwent a ventriculoperitoneal shunt as initial treatment.The diagnosis of fourth ventricle obstruction was made 5 months later when the patient came back complaining of headaches, cerebellar signs and cystic dilatation of the fourth ventricle on CT scan and MRI. Fourth ventricle Magendie's foraminoplasty via classic posterior fossa surgery brings complete cure.Conclusion: Magendie's foramen obstruction is rare. The embryological development of the posterior fossa and its content could explain the primitive obstruction which can be managed by classic surgery in case of unavaibility of endoscopy. 展开更多
关键词 Fourth ventricle outlets HYDROCEPHALUS magendie foramen OBSTRUCTION
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