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| 題 名 | Supratentorial Intracerebral Neuroepithelial Cysts : Review and One Case Report=小腦天幕上腦內神經上皮囊腫: 文獻分析與一病例報告 |
|---|---|
| 作 者 | 吳建忠; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 16:3 1983.09[民72.09] |
| 頁 次 | 頁281-295 |
| 分類號 | 415.93 |
| 關鍵詞 | 小腦天幕; 腦內神經; 上皮囊腫; |
| 語 文 | 英文(English) |
| 中文摘要 | 神經上皮囊腫是由原始神經管細胞演化而成的室管膜細胞及其衍生物所形成。它是一種先天性的疾病,關於形成的原因與機轉尚無定論。 位於小腦天幕以上,不與腦室或蜘蛛網膜下腔相溝通的腦內神經上皮囊種(本文討論的是室管膜囊腫與脈絡叢上皮囊腫)非常罕見。從1938年迄今,文獻僅記載26例室管膜囊腫(其中一例為作者之病例),一例脈絡叢上皮囊腫及一例轉移性上皮囊腫(細胞結構介於前二者之間)。 這28例神經上皮囊腫中,男性11例,女性17例。好發年齡為31-40歲(10例),25例為成人,3例為新生見。17例病灶位在左側,11例位在右側;最多見於額葉(13例),其次是額頂葉(4例)。成人常見症狀依次是癲癇(56%)、顱內壓升高症候群(36%)及各種漸進性神經功能障礙。新生兒的症狀皆是頭圍不正常增大。診斷的方法有腦室充氣攝影術、腦血管攝影術及電腦斷層攝影術等,尤以後者為佳;但是最後診斷仍有賴組織切片檢查。計有26例獲得組織病理檢查,其中有6例(合作者之一例)更作進一步的電子鏡檢查。28例病人中,有25例接受手術治療,有3例死於手術之前,但經屍體解剖而確定診斷。手術方法包括囊腫全摘除、部份摘除與多次穿制抽吸。術後經數月至數年不等,有5例發生復發。一般而言,囊腫部份切除並溝通囊腫與腦室或囊腫與蜘蛛網膜下腔的手術方法是治療原發或復發囊腫的理想方法。 本文同時報告作者1982年所治療的一例室管膜囊腫病人的臨床與病理特徵,並討論神經上皮囊腫形成的可能原因及其逐漸長大的可能機轉。 |
| 英文摘要 | Supratentorial intracerebral, or convexity neuroepithelial cyst (ependymal cyst and choroidal epithelial cyst) has been rarely reported. Since 1938, 26 cases of ependymal cyst (including the present case), one case of choroidal epithelial cyst and one case of a transitional type of epithelial cyst have been published in the literature. The clinicopathological features of these 28 cases are reviewed and analyzed.There were 11 males and 17 females. The patients ranged in age from 48 days to 74 years with a peak incidence from 31 to 40 years (10 cases). There were 3 infants who suffered from progressive enlargement of the head. Of the 25 adult patients ranging from 22 years to 74 years in age, 14 had a history of seizures. In 17 of the 28 cases the cyst was found on the left side, 11 on the right side, and most commonly (13 cases) in the frontal lobe. None of the cysts communicated with the ventricular system. Light microscopic examination of the cyst wall in 26 cases disclosed some hsitological variation. The cysts were lined with ciliated or non-ciliated epithelia positioned on glial or connective tissue or both. Electron microscopic examination was done in 6 cases (including the present case) and the fine structures are discussed in this paper. The most common method of surgical intervention was to remove the cyst roof and to make a communication between the cyst and the lateral ventricle. Most of the patients recovered post-operatively. |
本系統中英文摘要資訊取自各篇刊載內容。