Résumé
Intraparenchymal meningiomas without dural attachment are extremely rare, especially when they occur in basal ganglia region in child. An 8-year-old boy was admitted at our hospital, complaining of recurrent headache and vomiting for 3 months. Neurological examination showed impaired vision and mild paresis of the left extremities. Magnetic resonance imaging demonstrated a lesion located in the right basal ganglia region extending to superasellar cistern with solid, multiple cystic and necrotic components. Computed tomography revealed calcification within the mass. Due to the anterior cerebral artery involvement, a subtotal resection was achieved and postoperative radiotherapy was recommended. Histopathological examination indicated that the lesion was an atypical meningioma. The postoperative rehabilitation was uneventful. Mildly impaired vision and motor weakness of left extremities improved significantly and the patient returned to normal life after surgery. To our knowledge, intraparenchymal atypical meningioma in basal ganglia extending to superasellar cistern was never reported. The significance in differential diagnosis of lesions in basal ganglia should be emphasized.
Sujets)
Enfant , Humains , Mâle , Artère cérébrale antérieure , Noyaux gris centraux , Diagnostic différentiel , Membres , Céphalée , Imagerie par résonance magnétique , Méningiome , Examen neurologique , Parésie , Radiothérapie , Réadaptation , VomissementRésumé
Intraparenchymal meningiomas without dural attachment are extremely rare, especially when they occur in basal ganglia region in child. An 8-year-old boy was admitted at our hospital, complaining of recurrent headache and vomiting for 3 months. Neurological examination showed impaired vision and mild paresis of the left extremities. Magnetic resonance imaging demonstrated a lesion located in the right basal ganglia region extending to superasellar cistern with solid, multiple cystic and necrotic components. Computed tomography revealed calcification within the mass. Due to the anterior cerebral artery involvement, a subtotal resection was achieved and postoperative radiotherapy was recommended. Histopathological examination indicated that the lesion was an atypical meningioma. The postoperative rehabilitation was uneventful. Mildly impaired vision and motor weakness of left extremities improved significantly and the patient returned to normal life after surgery. To our knowledge, intraparenchymal atypical meningioma in basal ganglia extending to superasellar cistern was never reported. The significance in differential diagnosis of lesions in basal ganglia should be emphasized.
Sujets)
Enfant , Humains , Mâle , Artère cérébrale antérieure , Noyaux gris centraux , Diagnostic différentiel , Membres , Céphalée , Imagerie par résonance magnétique , Méningiome , Examen neurologique , Parésie , Radiothérapie , Réadaptation , VomissementRésumé
Objective To investigate the treatment of cystic craniopharyngiomas by CT-guided stereotactic neuroendoscopic resection and intratumoral chemotherapy. Methods 16 cases of cystic craniopharyngiomas were partial resected by CT-guided stereotactic neuroendoscopy. Intratumoral chemotherapy with bleomycin were given postoperatively. Results The clinical symptoms improved promptly after evacuations of cyst in all patients. No death or severe complications occurred. Follow-up (ranged from 2 to 3 years) CT or MRI indicated that the tumor cysts gradually regressed or disappeared. Conclusions The treatment of CT-guided stereotactic endoscopic resection and intratumoral chemotherapy for cystic craniopharyngioma is safe and effective, which should be a very useful procedure in clinical practice.