脑室内猪囊虫的诊断与治疗

Diagnosis and treatment of intraventricular cysticercosis

  • 摘要: 目的: 提高脑室内猪囊虫诊断和治疗水平。方法: 报告11例脑室内猪囊虫,并结合文献进行讨论。结果: 临床主要表现为阵发性头痛、呕吐、强迫性头位及后颅窝占位体征。CT均有脑积水。8例位于第四脑室。3例位于三脑室,其中1例因囊虫经室间孔突入一侧侧脑室,呈哑铃状,不仅三脑室扩大,一侧侧脑室体部亦局限性扩大,十分罕见。MRI见脑室内囊虫呈薄壁囊性占位及壁结节——虫头。结论: 依据囊虫在脑室内所处部位、大小不同,CT均有不同类型和程度的脑积水表现,但缺乏囊虫直接征象,而MRI可直接显示囊虫,结合临床多可明确诊断。只要诊断明确,予直接手术完整摘除,预后良好

     

    Abstract: Objective: In order to diagnose and treat the cases of intraventricular cysticercus correctly. Methods: Eleven cases of intraventricular single cysticercus were analysed retrospectivly. Results: Eight cysticerci were located in the fourth ventricle. Two were in the third ventricle. One in the third ventricle, passing through interventricular foramen into the right lateral ventricle. It is like dumbbell and exceptionally seen. Clinical manifestations included paroxysmal headache, vomiting, compelled head position and space occupying signs of the posterior cranial fossa. All patients had no epilepsy attack. In all cases we could see the ventriculus shape change and hydrocephalus by CT. Thin walled cystic space occupying lesion and attached wall cysticercus tubercle were showed by MRI. It is different from cerebral intraparenchymatous cysticercus in pathology because of lack of neuroglial cells proliferation around the cyst wall under light microscope. Conclusion: Only if the diagnosis of intraventricular cysticercosis is correct and intraventricular cysticercus is excised totally, a good outcome can be achieved.

     

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