[1]刘　伟　吴红星　帕尔哈提　杨小朋　冯冠军.小脑扁桃体下疝畸形合并脑室扩张的外科治疗[J].中国临床神经外科杂志,2015,(09):523-525.[doi:10.13798/j.issn.1009-153X.2015.09.004]
　LIU Wei,Wu Hong-xing,PA Er-ha-ti,et al.Surgical treatment of Chiari type 1 malformation associated with ventricular dilation[J].,2015,(09):523-525.[doi:10.13798/j.issn.1009-153X.2015.09.004]
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小脑扁桃体下疝畸形合并脑室扩张的外科治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年09期
页码:
523-525
栏目:
论著
出版日期:
2015-09-30

文章信息/Info

Title:
Surgical treatment of Chiari type 1 malformation associated with ventricular dilation
文章编号:
1009-153X（2015）09-0523-03
作者:
刘　伟　吴红星　帕尔哈提　杨小朋　冯冠军
830001 乌鲁木齐，新疆维吾尔自治区人民医院神经外科
通讯作者：吴红星，E-mail：hongxing1028@163.com
Author(s):
LIU Wei;  Wu Hong-xing;  PA Er-ha-ti;  YANG Xiao-peng;  FENG Guan-jun.
Department of Neurosurgery, People’s Hospital, Xinjiang Uygur Autonomous Region, Urumqi 830001, China
关键词:
小脑扁桃体下疝畸形; 脑室扩张; 后颅窝减压术; 疗效
Keywords:
Chiari malformation;  Ventricular dilation;  Posterior fossa decompression;  Curative effect
分类号:
R 742.8+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2015.09.004
文献标志码:
A
摘要:
目的 探讨小脑扁桃体下疝畸形合并脑室扩张的手术方法及其效果。方法 回顾性分析20例小脑扁桃体下疝畸形合并脑室扩张病人的临床资料，全部病例均采用后正中入路小骨窗枕下减压加自体筋膜减张缝合术。结果 全部病例术后MRI显示延颈髓压迫解除、枕大池形态恢复；术后20例病人均获得随访，平均随访24个月，2例症状完全消失，12例症状明显改善，5例症状无明显改变，1例症状加重；20例病人脑室大小均未见明显改变，无脑室扩张加重病例。结论 脑室扩张是小脑扁桃体下疝畸形先天畸形的一部分，而不是由于枕大孔区梗阻造成的梗阻性脑积水；小脑扁桃体下疝畸形合并脑室扩张患者颅内压多正常，在行枕下减压术前一般不需要行脑室外引流术，后正中入路小骨窗枕下减压术可取得良好效果，术后未发现有脑室进行性扩大或颅内压增高的现象。
Abstract:
Objective To study the approach of surgery for Chiari type 1 malformation (CM-1) associated with ventricular dilation and to evaluate the effect of posterior fossa decompression (PFD) on CM-1. Methods The clinical and imaging data of 20 adult patients with CM-1 who received PFD were analyzed retrospectively. The surgical procedures included the sub-occipital decompression and duraplasty with an autologous membranoid tendom graft. Results The postoperative MRI showed the relief of the cervicomedullary compression and recovery of the cisternae magnae. Twenty patients were followed up from 6 to 48 months (mean, 24 months). The symptoms disappeared in 2 patients, were improved in 12, unchanged in 5 and deteriorated in 1. The significant change in ventricular size was not observed in all the patients after the surgery. Conclusion It is suggested that ventricular dilation might be a part of Chiari malformation and is not produced by obstructive hydrocephalus because the intracranial pressure (ICP) is usually normal in all the patients with CM-1, in whom the treatment of the ventricular dilation is unnecessary before PFD. PFD combined with duraplasty is an effective and safe method to treat CM-1 associated with ventricular dilation, and no ventricular enlargement or increase in ICP was observed postoperatively.

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更新日期/Last Update: 2015-09-30