Objective To analysis the clinical characteristics and imaging features of encephalic cryptococcal granuloma and evaluate effectiveness of its treatment in children. Methods Clinical data of 3 children with confirmed encephalic cryptococcal granuloma which were confirmed by pathology after surgery were retrospectively analyzed. Results Three patients were female. The age of onset were 4 to 12 months and all had epilepsy. CT examination revealed abnormal intracranial space-occupying lesions with calcification, and the head MRI T1WI, T2WI showed a mixed signal anomalies. Pathological examination it had showed of the lesions after resection Cryptococcus neoformans and was partially calcified in all of patients. Surgery combined with antifungal and systematic antiepileptic treatment were effective. The prognosis was good with long-term follow-up. Conclusions Encephalic cryptococcal granuloma is a rare disease in childhood, especially in infancy. Patients with recurrent epilepsy with/without symptom of impaired local nervous system , combined with image of intracranial abnormal lesions should be suspected of encephalic cryptococcal granuloma. The final diagnosis depended on pathologic examination. Surgery combined with antifungal and systematic antiepileptic treatment was effective.%目的 探讨儿童颅内新型隐球菌肉芽肿的临床表现、影像学特征及诊治方法.方法 回顾性分析3例经手术后病理证实为新型隐球菌肉芽肿患儿的临床资料.结果 3例患儿均为女性,起病年龄4 ～ 12个月,均有癫(癎)发作.CT检查发现颅内异常占位病变伴钙化,头颅磁共振成像(MRI)示T1WI、T2WI均呈混杂异常信号.3例患儿切除病灶病理检查均可见特征性的新型隐球菌,部分钙化.手术切除病灶联合抗真菌治疗及对症抗癫(癎)治疗有效,长期随访预后良好.结论 儿童颅内新型隐球菌肉芽肿罕见,尤其是婴幼儿起病者;对于临床癫(癎)反复发作难以控制,伴或不伴局灶神经系统损害症状,结合影像学颅内有异常病灶者,应怀疑该病.病理诊断为确诊方法.手术切除病灶联合抗真菌治疗及对症抗癫(癎)的综合治疗方法有效.
展开▼
