首 页 | 杂志介绍 | 编委会 | 特约专家 | 期刊订阅 | 学术园地 | 学术公告
椎管内硬膜外脊膜囊肿
作者: 刘辉 岳树源 杨树源
单位:天津医科大学总医院神经外科; 天津医科大学总医院神经外科 天津;
关键词: 硬膜外脊膜囊肿 症状性囊肿 硬膜缺损 脊神经损伤 脊柱稳定性
分类号:
出版年·卷·期(页码):2008·34·第 2 期(0-0)
摘要:
硬膜外脊膜囊肿是椎管内的少见疾病,非外伤性硬膜外脊膜囊肿多由先天性因素造成。囊肿扩大的可能原因包括囊壁内层细胞的主动分泌、蛛网膜下腔与囊肿之间的渗透压梯度、搏动性脑脊液动力和瓣膜机制。囊肿常位于胸椎管的中下段,囊肿增大后可压迫脊髓,MR是诊断囊肿的首选方法。硬膜缺损是硬膜外脊膜囊肿的关键因素,手术治疗的目的不只是神经减压,更应是预防囊肿的复发。囊肿切除及硬膜缺损修补是首选的外科方法,同时将神经功能损伤及脊柱稳定性的破坏降到最低程度。1发病机理椎管内硬脊膜囊肿有多种表现形式,根据CT、脊髓造影、MR检查结合手术中探查情况及病理组织学检查结果,Nabors[1]将脊膜囊肿分为3型:Ⅰ型为不包含脊神经根的硬膜外脊膜囊肿,其中包括两个亚型,ⅠA硬膜外脊膜囊肿,ⅠB骶管内脊膜膨出;Ⅱ型为包含神经根的硬膜外脊膜囊肿,也称为Tarlov神经束膜囊肿;Ⅲ型为硬膜下脊膜囊肿。脊膜囊肿的发病机理不清,可由多种病因造成,其中包括先天性、外伤性及炎症性等原因。目前可将病因分为先天性及后天获得性[2]。硬膜外脊膜囊肿可以是先天性的硬膜憩室,也可以是蛛网膜疝入先天性的硬膜缺损。目前看来,硬膜缺损是造成硬膜外脊膜囊肿的决定性因素。从胚胎学...
参考文献:

中国期刊全文数据库 共找到 1 条

[1] 刘藏,赵雅度. 脊髓脊膜囊肿[J]. 中华神经外科杂志, 1998,(06) .
 

西文参考文献 共找到 23 条

[1] Chang IC. Thoracic neurenteric cyst in a middle aged adult presenting with Brown-Sequard syndrome .SPINE. 2003, 28(24) :515-518 .
 
[2] Uemura K,Yoshizawa T,Matsumura A,et al. Spinal extradural meningeal cyst.Case report[J] .J Neurosurg, 1996, 85 (2) :354-356 .
 
[3] Neo M,Koyama T,Sakamoto T,et al. Detection of a dural defect by cinematic magnetic resonance imaging and its selective closure as a treatment for a spinal extradural arachniod cyst[J] .Spine, 2004, 29 (19) :E426-430 .
 
[4] Fogel GR,Cunningham PY,Esses SI. Surgical evaluation and management of symptomatic lumbosacral meningeal cysts[J] .Am J Orhhop, 2004, 33 (6) :278-282 .
 
[5] Bassiouni H,Hunold A,Asgari S,et al. Spinal intradural juxt-amedullary cysts in the adult:surgical management and outcome[J] .Neurosurgery, 2004, 55 (6) :1352-1359 .
 
[6] Shibata T,Nakamura H,Yamano Y. Intradural arachnoid cyst as-sociated with thoracic spinal compression fracture:7-year followup after surgery .Spinal Cord, 2001, 39 (11) :599-601 .
 
[7] Alvisi C,Cerisoli M,Giulioni M,et al. Long-termresults of surgi-cally treated congenital intradural spinal arachnoid cysts[J] .J Neurosurg, 1987, 67 (3) :333-335 .
 
[8] Krings T, Lukas R, Reul J, et al. Diagnostic and therapeutic management of spinal arachnoid cysts .Acta Neurochirurgica. 2001, 143 :227 .
 
[9] Rabb CH,McComb JG,Raffel C,et al. Spinal arachnoid cysts in the pediatric age group:An association with neural tube defects[J] .J Neurosurg, 1992, 77 (3) :369-372 .
 
[10] Rohrer DC, Burchiel KJ, Gruber DP. Intraspinal extradural meningeal cyst demonstrating ball - valve mechanism of formation .Journal of Neurosurgery. 1993, 78 :122-5 .
 
[11] Uemura K,Komatsu Y,Shibata T,et al. Sacral meningeal cyst associated with valve-like mechanism[J] .Neurol Med Chir(To-koyo), 2001, 41 (5) :288-291 .
 
[12] Hamamcioglu MK,Kilincer C,Hicdonmez T,et al. Giant cervico-thoracic extradural arachnoid cyst:case report[J] .Eur Spine J, 2006, 15 (S5) :S595-S598 .
 
[13] Kurokawa R,Kawase T. Spinal arachnoid cyst causing paraplegia following skull base surgery[J] .Neurol Med Chir(Tokyo), 2006, 46 (6) :309-312 .
 
[14] Chang IC,Chou MC,Bell WR,et al. Spinal cord compression caused by extradural arachnoid cysts:clinical examples and review[J] .Pediatr Neurosurg, 2004, 40 (2) :70-74 .
 
[15] Lee HJ,Cho DY. Symptomatic spinal intradural arachnoid cysts in the pediatric age group:Description of three newcases and review of the literature[J] .Pediatr Neurosurg, 2001, 35 (4) :181-187 .
 
[16] McCrum C,Williams B. Spinal extradural arachnoid pouches:re-port of two cases[J] .J Neurosurg, 1982, 57 (6) :849-852 .
 
[17] Robinson Y,Reinke M,Haschtmann D,et al. Spinal extradural meningeal cyst with spinal stenosis[J] .Spinal Cord, 2006, 44 (7) :457-460 .
 
[18] Mummaneni PV, P itts LH, McCormack BM, et al. M icrosurgical treatment of symptomatic sacral Tarlov cysts .Neurosurgery. 2000, 47 :74 .
 
[19] Nabors MW, Pait TG, Byrd EB, et al. Updated assessment and current classification of spinal meningeal cysts .Journal of Neurosurgery. 1988, 68 :366 .
 
[20] Miyamoto M,Kim K,Matsumoto R,et al. Utility of preoperative magnetic resonance imaging myelography for identifying dural de-fects in patients with spinal extradural arachniod cysts:case report[J] .Neurosurgery, 2006, 59 (4) :E941 .
 

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
[email protected] 《中国神经精神疾病杂志》编辑部 中山大学附属第一医院期刊中心
地址:广州中山二路58号中山大学附属第一医院门诊楼13楼 邮编:510080 电话:020-87332686 87331494 EMAIL:[email protected]
粤ICP备10090623号-1
技术支持:北京志清伟业科技发展有限公司