60例侧裂池蛛网膜囊肿伴癫痫的手术治疗  

Surgical treatment of 60 cases of sylvian cistern arachnoid cysts complicating epilepsy

作　　者：王子璕[1] 汪润 韩圣[1] WANG Zixun;WANG Run;HAN Sheng(Department of Neurosurgery,First Affiliated Hospital of China Medical University,Shenyang,Liaoning 110001,China)

机构地区：[1]中国医科大学附属第一医院神经外科,沈阳110001

出　　处：《重庆医学》2020年第6期967-969,共3页Chongqing medicine

摘　　要：目的探讨侧裂池蛛网膜囊肿伴癫痫的临床特点、手术适应证和术式选择。方法回顾性分析2006年1月至2016年1月中国医科大学附属第一医院神经外科手术治疗的60例侧裂池蛛网膜囊肿伴癫痫患者的临床资料。所有患者均行显微镜下囊肿切除联合脑池沟通术。60例患者中18例行致癫痫灶切除术,6例行皮质电凝热灼术。结果所有患者手术过程均较顺利,术后未出现严重并发症。患者术后症状及影像学表现均有不同程度的改善,术后癫痫完全不发作36例,发作得到显著改善24例。结论侧裂池蛛网膜囊肿存在继发癫痫的可能性,明确诊断后可行显微镜下囊肿切除联合脑池沟通术,术中可在脑电监测下同时处理癫痫病灶,这是治疗该类疾病的关键。Objective To investigate the clinical characteristics,surgical indications and surgical method selection of sylvian cistern arachnoid cysts complicating epilepsy.Methods The clinical data in 60 patients with sylvian cistern arachnoid cyst complicating epilepsy surgically treated in the neurosurgical department of First Affiliated Hospital of China Medical University were retrospectively analyzed.All patients underwent microscopic cyst excision and cystocistern fenestration.Among 60 cases,18 cases underwent the excision of epileptic focus and 6 cases underwent the electro-coagulation on cerebral cortexes.Results The operative course in all cases was smooth without no postoperative severe complication.The postoperative symptoms and imaging manifestation in all cases had different degrees of improvement.Thirty-six cases had no attack of epilepsy after operation,and 24 cases had significant improvement.Conclusion The possibility of secondary epilepsy exists in sylvian cistern arachnoid cyst,after definitely diagnosing,the microscopic cyst excision can be performed,during operation,the epilepsy focus may be simultaneously treated under the EEG monitoring,which is the key for treating this kind of disease.

关 键 词：蛛网膜囊肿 癫痫 手术治疗 

分 类 号：R651.11[医药卫生—外科学]