目的:探讨蛛网膜囊肿合并慢性硬膜下血肿的临床特点与外科治疗方法。方法:回顾分析苏州大学附属第一医院神经外科及伊犁医院自2021年1月至2024年3月收治蛛网膜囊肿合并慢性硬膜下血肿患者3例,其中1例患者行开颅囊肿剥除 + 硬膜下血肿清除术,另1例患者行神经内镜下囊肿切除 + 硬膜下血肿清除术,最后1例患者行单侧硬膜下血肿钻孔引流术。回顾性分析患者的临床资料和疗效,并且结合文献(对PubMed、Embase、Cochrane Library、Medline、中国知网、万方、维普等数据库进行系统的文献检索)进行总结。结果:选择硬膜下血肿钻孔引流术与神经内镜下囊肿切除 + 硬膜下血肿清除术的两例患者为儿童,术后随访2年,蛛网膜囊肿与血肿均无复发;1例行开颅囊肿剥除 + 硬膜下血肿清除术患者为青年男性,术后复查CT存在少量硬膜外血肿,经引流后,患者术后恢复良好。通过文献复习蛛网膜囊肿合并慢性硬膜下血肿的病人,总结其临床特征及外科治疗方法。IAC合并CSDH少见,通常发生于青年人,常发生于囊肿的同侧,外伤、剧烈运动是发生慢性硬膜下血肿的主要诱因;蛛网膜囊肿合并慢性硬膜下血肿患者的治疗一般选择钻孔引流术;对于囊肿或者血肿复发的患者,无需急于再次钻孔或者急于行针对囊肿的手术,可随访观察;对于出血前囊肿就有症状或者囊肿反复出血的患者,可以在血肿清除同时切除囊肿。结论:蛛网膜囊肿合并慢性硬膜下血肿患者的外科治疗包括钻孔引流术、神经内镜下囊肿切除 + 硬膜下血肿清除、显微镜下囊肿切除 + 硬膜下血肿清除,可以取得较好的手术疗效。Objective: To investigate the clinical characteristics and surgical treatment of arachnoid cyst combined with chronic subdural hematoma. Methods: Review analysis of the first affiliated hospital of Suzhou university neurosurgery and Yili hospital from January 202
目的:分析Sternberg管未闭的病因、临床特点,并指导临床诊断及治疗。方法:收集近1年本医疗组治疗Sternberg管未闭患者的临床资料,并检索国内外数据库收集相关病例进行回顾性分析。结果:2例病例均有明确Sternberg管未闭伴脑膜脑膨出的影像学特征,经过手术治疗后未见明显脑脊液漏表现。文献检索共得相关研究22篇,其中病例为51例,以自发性脑脊液鼻漏为主要症状,均有明确蝶窦骨质缺陷,手术治疗预后良好。结论:Sternberg管人群中发病率低,主要引起不明原因的脑脊液鼻漏。其临床诊断困难,但手术可治愈,预后好,复发率低。Objective: To analyze the etiology and clinical characteristics of patent Sternberg’s Canal, and to guide clinical diagnosis and treatment. Method: We collect clinical data of patients with patent Sternberg’s Canal treated in our medical group in recent years and retrieve relevant cases from Chinese and foreign databases for retrospective analysis. Result: Both two cases had explicit imaging features of patent Sternberg’s Canal along with meningoencephalocele. No obvious cerebrospinal fluid leakage was observed after surgical treatment. A total of 22 relevant studies were obtained through literature search, including 51 cases, with spontaneous cerebrospinal fluid rhinorrhea as the main symptom. All of them had clear sphenoid sinus bone defects and had good prognosis after taking surgical treatment. Conclusion: In epidemiology, the incidence rate in Sternberg’s Canal is low, which mainly causes cerebrospinal fluid rhinorrhea of unknown causes. It is difficult to make clinical diagnosis, but it can be cured by surgery, with good prognosis and low recurrence rate.
