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NEJM：蛛网膜囊肿-案例报道

2017-06-08 xing.T MedSci原创

蛛网膜囊肿头痛癫痫
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蛛网膜囊肿是先天性畸形，内充满脑脊液，它们可以在偶然大脑成像结果中发现。当囊肿变大，正如在这名患者，它们可以导致体积占位效应。

患者为一名27岁男性，因首次癫痫发作后被送到急诊科就诊。该患者报告在过去的3年里经常头痛和跌倒。磁共振成像检查显示大脑存在蛛网膜囊肿，大小为16.5厘米*7.9厘米*12.3厘米，在右侧大脑半球存在体积占位效应；囊肿引起颞叶向上、向后位移和中线结构移位。


蛛网膜囊肿是先天性畸形，内充满脑脊液，它们可以在偶然大脑成像结果中发现。当囊肿变大，正如在这名患者，它们可以导致体积占位效应。

该患者经开颅手术打开蛛网膜囊肿，随后，放置右侧额叶囊肿腹腔分流，因为持续升高的颅内压。重复进行影像学检查后，这些干预措施并没有引起囊肿大小发生实质性的变化。

病人仍然每天都有头痛，并且已经将抗癫痫治疗药物写入处方中，以防止癫痫发作。

原始出处：

Jennifer de Longpre,et al. Large Arachnoid Cyst.N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1610483

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    2017-07-04 aliceclz

    #蛛网膜#

    0

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    2017-06-09 12498ca5m83暂无昵称

    #囊肿#

    0

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content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-09 小大夫快跑

    这么大

    0

  4. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Thu Jun 08 09:47:12 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208106, encodeId=4dc2208106fb, content=不错的，学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 08 09:29:20 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208089, encodeId=396d20808902, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-09 meiliwuxian

    这么严重

    0

  5. 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content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-09 tanxingdoctor

    学习啦谢谢分享

    0

  6. 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content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 wangxy0513

    可以考虑内镜下囊肿造瘘

    0

  7. 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content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 158****8818

    值得学习，临床需要注意

    0

  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Thu Jun 08 09:47:12 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208106, encodeId=4dc2208106fb, content=不错的，学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 08 09:29:20 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208089, encodeId=396d20808902, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 执迷不悔

    学习了

    0

  9. 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content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 中医痴

    不错的，学习了！谢谢分享！

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/y6Sk2KiaDibWSs0icexcRzKWXKao9dILdyaB6olvWApA1uiaapa4T9XMiaU7hTZA04uj2iavabfdCT5iaO6AYue5qSJ7MzXaAVSqh6j/0, createdBy=08e01983553, createdName=执迷不悔, createdTime=Thu Jun 08 09:47:12 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208106, encodeId=4dc2208106fb, content=不错的，学习了！谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 08 09:29:20 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208089, encodeId=396d20808902, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Jun 08 08:48:30 CST 2017, time=2017-06-08, status=1, ipAttribution=)]
    2017-06-08 楠博One

    学习谢谢分享

    0

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