증후성 거대 지주막 낭종 3례

Three Cases of Symptomatic Huge Arachnoid Cysts

발달 지연, 영아 연축, 및 성조숙증의 증상으로 발견된 후두개와의 거대 지주막 낭종 3례에 대하여 수술 및 약물 치료를 시행하였다. 증후성 지주막 낭종은 발생 부위, 크기, 증상 등을 고려하여 조기에 수술적 치료를 시행함으로써 신경학적 손산과 발달 지연을 최소화 할 수 있을 것으로 사료된다.

Congenital arachnoid cysts are commonly located at sylvian cistern or middle cranial fossa which are usual)y asymptomatic and incidentally found. Posterior fossa cysts, however, are usually large when diagnosed, and symptomatic. Three cases of large posterior fossa cysts were recognized on the diagnostic MRI investigation for infantile spasm, developmental delay, and the precocious puberty. Surgical decompression of the cysts by craniectomy, cyst excision and fenestration were performed successfully in two patients with arachnoid cysts in the cerebellopontine cistern and the suprasellar, right cerebellopontine, and prepontine cisterns, but an additional cystoperitoneal shunt was needed in a case with the cyst in the quadrigemial cistern with obstructive hydrocephalus. Infantile spasm was treated with vigabatrin and pyridoxine, and the true precocious puberty was managed with LHRH analogue(Decapeptyl？？).