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自1952年Taarnhφj氏首创三叉神经半月节减压术以来,并发症极少,虽有文献报道手术野出血、感觉异常、暂时性面瘫以及疼痛复发者,而并发颞叶肉芽肿者,尚未见报道,作者报道一例55岁女性患者,因局限性癫痫入院。住院前一年内因右半身抽搐、失语共三次。15年前患者曾有左侧三叉神经痛,且做了同侧半月神经节减压术。检查患者,有感觉性和运动性失语,对年份命名困难,记忆及理解能力差,定向力可。瞳孔左比右大1毫米,光反应左侧差。无视乳头水肿。视野为右颞侧上象限缺损。右侧辨距不良及反射稍增强。双侧巴彬斯基征阳性。无感觉丧失。痉挛步态且基底宽。~(99m)Tc扫描发现左颞顶部放射线增加。左颈动脉造影发现左颞叶无血管区。EEG提示左颞部局限性慢波。计算机断层扫描提示左颞有病变,其周围有水肿。经左颞开颅,发现颞叶脑组织色黄、脑回宽平,约在3
Since Tanomhφj’s first trigeminal half-moon decompression in 1952, there have been few complications. Although there have been reports in the literature of surgical bleeding, paresthesias, temporary facial paralysis, and recurrence of pain, those with concurrent temporal lobe granuloma have not been reported. The authors report a case of a 55-year-old female patient admitted to hospital because of limited seizures. There was a total of three times of convulsions and aphasia in the right body during the first year of hospitalization. Fifteen years ago, the patient had left trigeminal neuralgia and performed ipsilateral half-moon ganglion decompression. Examination of patients, there are sensory and motor aphasia, naming the years difficult, poor memory and understanding, orientation can be. The left pupil is 1 mm larger than the right, and the left side of the light response is poor. Ignore papillary edema. The visual field is the upper right quadrant defect. Poor discrimination and reflection on the right side are slightly enhanced. The bilateral Babinski sign is positive. No loss of feeling.痉挛 gait and wide base. A ~(99m)Tc scan revealed increased radiation at the top of the left iliac crest. Left carotid artery angiography found avascular area of the left temporal lobe. The EEG suggested a slow wave in the left temporal region. Computed tomography revealed a lesion in the left eyelid with edema surrounding it. After left craniotomy, it was found that the temporal lobe had a yellowish brain and a wide gyri, approximately 3