Cerebral arachnoid cyst endoscopic surgery

Cerebral arachnoid cysts are mostly located in the anterior temporal, lateral, quadrant, and occipital foramen, and their surgical treatment methods are different. Endoscopic treatment of brain arachnoid cysts, surgical trauma is small, the effect is positive, but the long-term effect remains to be further observed. Schroeder et al (1996) reported 7 cases of follow-up 15 to 30 months after surgery, the original symptoms improved and CT or MRI review confirmed that the brain arachnoid cyst was reduced in 6 cases. Treating diseases: arachnoid cysts Indication 1. Accompanied by high intracranial pressure symptoms. 2. With local nerve compression symptoms. 3. Arachnoid cysts have a tendency to gradually expand. Contraindications Atypical arachnoid cysts. Preoperative preparation 1. There must be a correct positioning diagnosis before surgery. In recent years, due to advances in imaging inspection technology, clinical applications such as CT, MRI, and DSA have become increasingly widespread. The relationship between the location of the lesion and the surrounding structure should be analyzed before surgery in order to select the appropriate surgical approach, to obtain the best exposure, avoid the important structure of the skull as much as possible, increase the safety of the operation and strive for good Effect. 2. Skin preparation, wash the head with soap and water 1 day before the operation, shave the hair on the morning of the operation. You can also shave your head on the eve of surgery. 3. Fasting the morning of surgery. It can be enema in the evening before surgery, but when the intracranial pressure is increased, the enema should be removed to avoid sudden deterioration of the condition. 4. Give phenobarbital 0.1g orally before surgery to ensure a quiet rest. One hour before the operation, 0.1 g of phenobarbital, 0.4 mg of atropine or 0.3 mg of scopolamine were intramuscularly injected. 5. Prepare the endoscopic surgery equipment. Surgical procedure 1. A small incision in the scalp adjacent to the lesion, and the skull is drilled, with a diameter of 1 to 2 cm. 2. Cut the dura mater, insert the endoscope into the cyst, and find the adjacent cerebral cistern to open the window with bipolar electrocoagulation. The anterior cyst of the temporal lobe is connected with the carotid artery pool, the lateral fissure cyst is connected with the lateral fissure pool, and the cyst in the large occipital region is connected with the occipital pool or the diverticulum, and then the cyst wall is treated. The adhesion of the cyst wall is not heavy, and the exfoliation and microsurgery can be completely or largely removed, but those who are closely adherent to important brain regions or blood vessels cannot be reluctantly removed. 3. After careful hemostasis, remove the endoscope. 4. Guan skull. complication The earliest and most serious complication after surgery is intracranial hemorrhage. A common cause is that hemostasis is not complete during surgery. Patients with concurrent intracranial hemorrhage, or delayed waking after surgery, or apathy, lethargy, headache, vomiting, seizures or re-coma after waking. Therefore, there is no special reason after surgery for a long time, not awake or consciousness is gradually worsened, and signs of increased intracranial pressure such as slow pulse, elevated blood pressure, or new neurological symptoms should be paid attention to, should be highly alert to the skull The possibility of internal bleeding. CT examination should be performed in time when conditions are met, and the hematoma should be removed immediately after diagnosis. The earlier the surgery, the better the consequences.

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