脑囊虫病微创手术治疗19例

摘要

目的 评价应用神经内镜,立体定向技术等微创手术治疗脑囊虫病的方法及疗效.方法 回顾分析19例脑囊虫病的临床特点、 影像学表现和行神经内镜、 立体定向等微创手术方法及治疗效果.9例单纯神经内镜下嚢虫摘除,7例立体定向引导下完成,2例行透明隔造瘘并脑室腹腔分流术.结果 19例患者中17例完全切除病灶,2例三脑室内嚢虫术中1例出血未取出囊虫,另1例发现嚢虫移位致侧脑室后份无法取出.术后随访2月至5 a,所有病例未发生新神经功能损伤,16例术前症状消除,3例脑电图有癫痫波,1例癫痫大发作,1例部分性癫痫发作.结论 使用神经内镜,立体定向技术等微创手术方法治疗脑囊虫病创伤小,疗效肯定.%Objective To evaluate the operational methods and therapeutic efficacy of minimally invasive operation with neuroendoscopy and stereotactic techniques in treatment of neurocysticercosis.Methods The clinical characteristics and imaging appearances of 19 patients with neurocysticercosis received minimally invasive operational treatment with neuroendoscopy and Stereotactic techniques were analyzed and summaried retrospectively,9 cases of neurocysticercosis were lonely extirpated by neuroendoscopy,7 cases were completed under the guide of stereotactic techniques,2 cases of septum pellucidum fenestration and ventriculoperitoneal shunt.Results Among 19 cases of patients,there were 17 cases of total resection,2 cases of unsuccessful removal of third ventricle cysticercus because of hemorrhage during operation or Cysticercus movement to the posterior of Lateral Ventricles. All patients were followed up for 2-60 months,in all cases,no new neurological function defect was found,16 cases of preoperative symptoms disappeared,3 cases of epileptiform EEG,1 case of grand mal,1 case of partial seizure disorder.Conclusion Minimally invasive treatment with neuroendoscopy and stereotactic techniques for neurocysticercosis has smaller trauma and definite curative effect.