脑室内神经囊虫病的“满月”内窥镜征象。

Minimally Invasive Neurosurgery Pub Date : 2011-04-01 Epub Date: 2011-06-07 DOI:10.1055/s-0031-1275735
R Ramos-Zúñiga, J de La Cruz-Ramírez, P M Casillas-Espinosa, J A Sánchez-Prieto, M D S López-Hernández
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引用次数: 9

摘要

导言:尽管在卫生、诊断和治疗方面有所改善,但神经囊虫病在许多国家仍然是一个公共卫生问题。在有症状的患者中,有广泛的临床表现。当囊虫滞留在脑室或蛛网膜下腔时,脑脊液的流动会受阻,导致脑积水和颅内高压。内窥镜可以作为一种有用的诊断工具。患者:本报告清楚地显示了4例室性囊虫病(2例第三脑室/2例侧脑室)的共同内镜模式。脑室囊肿的内窥镜图像类似“满月”。这种类比有助于识别囊尾蚴壁完整和囊泡期的特征,由于其囊性内容物而具有延展性,表面不规则,作为囊尾蚴囊壁微观结构的证据。结论:这一发现在其他脑室内囊肿或肿瘤中未见,实际上可以被视为确定囊虫病诊断的附加诊断标准,因为它涉及在组织病理学证明下直接内镜下囊虫的可视化。此外,内窥镜入路可作为这些病例的主要治疗方法,遵循微创入路原则。
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"Full moon" endoscopic sign in intraventricular neurocysticercosis.

Introduction: Despite improvements in sanitation, diagnosis and treatment, neurocysticercosis is still a public health problem in many countries. In symptomatic patients, there is a broad spectrum of clinical manifestations. When cysticerci are lodged in the ventricles or the subarachnoid space, the flow of cerebrospinal fluid can be obstructed and lead to hydrocephalus and intracranial hypertension. The endoscopic view may be useful as a diagnostic tool.

Patients: This report clearly shows a common endoscopic pattern in 4 selected patients with ventricular cysticercosis (2 third ventricle/2 lateral ventricle). The endoscopic view of the cysts in the ventricles resembles a "full moon". This analogy helped to identify the features of cysticerci with intact walls and the vesicular stage, malleable due to its cystic content and having an irregular surface, as evidence of the microscopic structure of the cyst wall in a cysticercus.

Conclusions: This finding is not seen in other intraventricular cysts or tumors that can actually be considered as an additional diagnostic criterion among the definitive findings to establish the diagnosis of cysticercosis, since it involves direct endoscopic visualization of a cysticercus under histopathological demonstration. Additionally, the endoscopic approach can be used as primary treatment for these cases, following the minimally invasive approach principle.

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来源期刊
Minimally Invasive Neurosurgery
Minimally Invasive Neurosurgery 医学-临床神经学
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