通过内窥镜鼻内镜手术治疗一名男孩的拉氏裂囊肿栓塞：病例报告和文献综述

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY Neurochirurgie Pub Date : 2024-02-13 DOI:10.1016/j.neuchi.2024.101540

Hongpeng Guan , Ying Zhang , Xuhui Wang

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摘要

拉氏裂隙囊肿（RCC）栓塞是一种不常见的病变，是由于脆弱的 RCC 上皮壁血管供应异常所致。这种病在儿童中非常罕见，未经病理证实很难诊断。在此，我们报告了一名因头痛和视力障碍而就诊的 8 岁男孩。核磁共振成像和 CT 显示，蝶鞍区有一个囊性肿块。他接受了鼻内镜手术，经蝶窦入路完全切除了囊性肿块。通过术中观察和组织病理学检查，证实病变为 RCC 中风。术后头痛完全缓解，视野缺损明显改善。尽管目前还没有针对小儿 RCC 中风的标准化治疗指南，但作者建议对出现严重神经眼科症状或意识恶化的小儿 RCC 中风患者进行手术治疗。

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Rathke’s cleft cyst apoplexy in a boy treated by endoscopic endonasal surgery: case report and literature review

Rathke’s cleft cyst (RCC) apoplexy is an uncommon lesion attributed to abnormal vascular supply to the fragile RCC epithelial wall. It is rare in children and very difficult to diagnose without pathologic confirmation. Here, we report an 8-year-old boy who presented with headache and visual deficit. MRI and CT showed a cystic mass in the sellar region. He underwent endoscopic endonasal surgery, and the cystic mass was resected completely via a trans-sphenoidal approach. The lesion was confirmed as RCC apoplexy by intraoperative observation and histopathological examination. Headache was completely relieved and the visual field deficit improved remarkably after the operation. The authors recommend surgical management for pediatric RCC apoplexy patients who present with severe neuro-ophthalmic signs or deterioration of consciousness, although there are at present no standardized management guidelines for pediatric RCC apoplexy.

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.