34周的胎儿的了蛛网膜囊肿57*36mm
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34周的胎儿的了蛛网膜囊肿57*36mm,我该怎么办？
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指导意见：蛛网膜囊肿，为良性脑囊肿的一种。有蛛网膜样囊壁及脑脊液样的囊液。是没有太大的问题的，如果不放心的话，可以中止妊娠的。医生询问：
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网膜囊肿(omentalcyst)是罕见病，仅占网膜疾病的5%左右，其发病率远较肠系膜囊肿为低，二者之比约为1∶5。大网膜囊肿位于网膜的两层膜之间，分为真性囊肿和假性囊肿，前者多是由于先天的异位淋巴组织异常发育或淋巴管梗阻所致，其囊壁薄，壁内被覆单层内皮细胞，可为单房或多房，内容物多是淡黄色浆液和乳...
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常见症状腹部胀满感、、、、腹部可扪及肿块、
检查项目腹部X线平片、钡餐检查、B超检查、腹腔动脉造影、
其他信息治疗费用、是否传染、好发人群
活血破瘀，通经消痞。用于瘀血内停之腹部肿块、肌肤甲错、目...
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活血破瘀，通经消痞。用于瘀血内停之腹部肿块、肌肤...
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方法二：点击浏览器上的收藏按钮收藏问题。宫内孕单活胎蛛网膜囊肿？枕大池增宽 羊水量多 请问 这些情况应该注意什么 对胎儿有什么影响_百度知道
问:宫内孕单活胎蛛网膜囊肿？枕大池增宽 羊水量多 请问 这些情况应该注意什么 对胎儿有什么影响
孕妇做的超声检查
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来自汉滨医院
称为羊水过多，凡在妊娠后期羊水量超过2000毫升者。羊水过多的处理。急性多发生于妊娠16-24周羊水过多正常妊娠时的羊水量随孕周增加而增多，来势凶猛，根据发病时间羊水增加速度不同分为急，如胎儿无畸形，酌情使用镇静剂，可给低盐饮食，主要取决于胎儿是否有畸形以及孕妇压迫症状是否严重，妊娠足月的羊水量约为1000毫升。症状较轻孕妇无明显下适；慢性发生于妊娠后期在数周内渐增多，行人工破膜引产，严密观察羊水量的变化直至足月分娩。如果压迫症状严重或胎儿有畸形者、慢性，最后2-4周开始逐渐减少。均应立即终止妊娠
这种情况目前来说在胎儿期没有什么治疗的办法。只能观察着，或者做染色体分析判断胎儿...
您好，根据您以上详细描述的，您目前的情况考虑应该是怀孕后孩子脑部囊肿，发育异常，...
囊肿饮食应忌辛辣刺激类：如辣椒等;忌酒类,吸烟（包括被动吸烟）;忌巧克力,咖啡,海鱼,...
需要看严重性的 ，可以再观察看看的 ，再孩子出生之后也可以选择手术治疗的。
你好，如果是没有任何的症状，可以进行继续观察变化，一旦出现症状或者持续性增长的情...
* 百度知道专家平台解答内容由公立医院医生提供，不代表百度立场。* 由于网上问答无法全面了解具体情况，回答仅供参考，如有必要建议您及时当面咨询医生|/|/|/|/|/|
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【读片】产科疑难病例（190）:脑半球间蛛网膜囊肿
We present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was unremarkable. An amniocentesis was performed and the karyotype was normal (46, XX), as was the AFP result. Here are some images we obtained.患者，25岁，G1P0，孕13周时进行检查。既往病史无异常，羊膜穿刺术显示核型正常（46，XX），AFP正常。
screen.width-333)this.width=screen.width-333" width=390 height=300 title="Click to view full 1A.jpg (390 X 300)" border=0 align=absmiddle>We present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was unremarkable. An amniocentesis was performed and the karyotype was normal (46, XX), as was the AFP result. Here are some images we obtained.患者，25岁，G1P0，孕13周时进行检查。既往病史无异常，羊膜穿刺术显示核型正常（46，XX），AFP正常。
screen.width-333)this.width=screen.width-333" width=390 height=300 title="Click to view full 1B.jpg (390 X 300)" border=0 align=absmiddle>We present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was unremarkable. An amniocentesis was performed and the karyotype was normal (46, XX), as was the AFP result. Here are some images we obtained.患者，25岁，G1P0，孕13周时进行检查。既往病史无异常，羊膜穿刺术显示核型正常（46，XX），AFP正常。
screen.width-333)this.width=screen.width-333" width=390 height=390 title="Click to view full 2A.jpg (390 X 390)" border=0 align=absmiddle>We present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was unremarkable. An amniocentesis was performed and the karyotype was normal (46, XX), as was the AFP result. Here are some images we obtained.患者，25岁，G1P0，孕13周时进行检查。既往病史无异常，羊膜穿刺术显示核型正常（46，XX），AFP正常。
screen.width-333)this.width=screen.width-333" width=390 height=390 title="Click to view full 2B.jpg (390 X 390)" border=0 align=absmiddle>部分颅骨缺失,脑膜膨出可能.图1：看不到这时期应该是很清楚的脑室及脉络丛结构；看不到脑中线结构（不知道是不是切面的原因）；眼距窄？――虽然羊膜穿刺术显示核型正常（46，XX），但还是要考虑前全脑可能。图2－4：考虑部分颅骨缺失，脑膜膨出可能。我觉得象硬膜下囊肿呀,考虑部分颅骨缺失，脑膜膨出。确实很难。分析：1.颅盖成巨大膨处状，因与面颅骨质延续，故不支持颅骨缺损并脑膜膨出改变，考虑颅骨畸形改变。这种情况可以考虑羊膜带综合征的颅骨改变，但本例缺乏直接证据。2.颅盖膨出部分，内部为液性回声，考虑为脑脊液。颅底附近和膨出的侧壁可以看到脑组织结构，故考虑脑积水的改变。3.目测眼间距较小。4.本例有脑积水改变，提示有不典型DandyCWalker氏综合征的可能。但是，本例还有眼间距较小，更支持全前脑畸形。但这个颅骨突出如何用一元观点解释？从图片来看，积水虽然明显，但一般可造成脑颅的总体增大，不造成局限性的突出。诊断：考虑颅骨畸形并全前脑畸形。相关资料：wxymy9612 战友的资料（ >
）：全前脑畸形又称为前脑无裂畸形，是指前脑未完全分开成左右两叶，而导致一系列脑畸形以及由此而引起的一系列面部畸形。本病常与染色体畸形如13―三体， 18-三体，18号染色体短臂缺失有关。根据大脑半球分开程度，分为三种类型：1.
无叶前全脑：最严重，大脑半球完全融合未分开，大脑镰及半球间隙缺失，仅有单个脑室，丘脑融合成一个。2.
半脑前全脑：为一种中间类型，介于无叶前全脑和叶状前全脑之间，大脑半球和侧脑室仅在后侧分开，前方仍相连，仍为单一脑室，丘脑常融合或不完全融合。3.
叶状前全脑：大脑半球及脑室均完全分开，大脑半球的前后裂隙发育尚好，丘脑分为左右两个，但仍有部分融合，如透明隔消失。由于前全脑畸形胎儿大脑皮质发育差，常出现小头畸形，但合并脑积水时胎头常增大。由于大脑半球不分开，常形成一系列不同程度的面部中线结构畸形。眼畸形：眼距过近，独眼畸形，眼眶融合成一个，甚至眼球融合成一个，小眼球、无眼球；鼻畸形：无鼻、扁平鼻，单鼻孔畸形，无鼻孔长鼻畸形或象鼻畸形，长鼻常位于独眼眶的上方；中央唇裂，两侧唇裂，腭裂、小口畸形。其他尚有前连合缺如、锥体束缺如或形成不全、脑血管异常、垂体缺如、脑干发育不全等；脑以外的畸形有先心病、内脏转位、生殖泌尿道畸形、手足畸形、副脾等。超声诊断：根据单一侧脑室，丘脑融合，脑中线结构如透明隔腔及第三脑室消失，胼胝体消失，脑组织变薄，不能显示正常的脑结构，脑积水，第四脑室增宽，后颅窝增宽，以及面部畸形如眼距过近，独眼畸形，以及无鼻、单鼻孔畸形，唇裂等，超声可以得出诊断。无叶前全脑早孕期不能显示大脑镰，胎头呈气球样。 个人理解：
（缩略图，点击图片链接看原图）看了老杏老师的分析，深受启发。此病例提出AFP正常，提示开放性神经管畸形，胎儿脑脊液外漏的可能性不大。当初下前全脑的诊断时，其实心里也是有犹豫的：除了脑积水、目测胎儿眼距缩短之外，其他证据都可因切面、病理生理变化而不确切；更重要的是病例提出了胎儿羊膜腔穿刺染色体检查无异常（虽说也有一些前全脑与染色体病无关）。另外，超声发现胎儿头颅形态异常时，除了考虑继发改变，还应考虑颅骨的原发病变。因此，修正诊断为：首先考虑胎儿颅缝骨化综合征（Craniosynostosis syndrome）：尖头畸形（oxycephaly）？；并胎儿脑积水。其次，前全脑待排。请问楼主，有结果吗？非常喜欢看大家的分析，尤其是老杏。很让人长见识。谢谢。-----仅从病例图片表现来试着分析一下。-----首先，病例图片显示的是胎儿头颅形态明显失常，上尖，部分颅骨不延续，颅内脑组织受压。第一、二张图片是不是显示了颜面部双眼切面，不好说。-----当然，露骨不延续首先考虑的是脑膜膨出及脑膜脑膨出。但是本例显示胎儿头顶明显变尖向外膨窿，对局部颅骨及脑组织的压迫似乎力量很大。-----没见过这么大的脑膜膨出。除非脑膜膨出合并外周脑脊液容量的急剧增加。-----但是从图二观察，我更倾向于颅内巨大囊性占位，向内压迫脑实质，向外压迫颅骨，造成颅缝增大，形成颅骨不延续的表现。加上自己对图片2的理解：红色部分显示巨大囊性结构绿色部分显示头皮结构兰色部分显示颅骨结构。红色箭头显示囊性结构对头皮的外撑形成的角度。
screen.width-333)this.width=screen.width-333" width=390 height=300 title="Click to view full cdp0002.jpg (390 X 300)" border=0 align=absmiddle>患者，25岁，G1P0，孕13周时进行检查。既往病史无异常，羊膜穿刺术显示核型正常（46，XX），AFP正常
从图像上分析:
颅骨光环圆形，未见正常脉络膜及脑中线
塌鼻，眼距窄
从颅骨的右后可见突出的囊性区，周边未见明显颅骨光环
3D图可见明显的头颅异常
胎儿为46XX正常核型
超声提示：
胎儿颅骨发育异常:缺失?膨出?
胎儿颅内结构异常
胎儿颜面异常：塌鼻，眼距窄综合上面几位意见，在公布答案前最后修正诊断：前全脑，并背侧囊肿（dorsal sac），理由：由于原始脑半球的内旋转受到干扰，脑室顶的薄膜不能卷入脑实质内，随着脑脊液的增加，形成一位于颅骨与大脑皮层间的囊肿。同意6627758战友的分析,单就图二分析,如果考虑颅骨缺损后脑膜膨出的话,而脑组织应该向外膨出一点,而在图中感觉是向内凹,所以考虑是否是有个囊性占位的存在，三维图像看不太懂，因为医院尽管也有三维的设备，但本人做得不多．We present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was unremarkable. On sonography we found a live pregnancy with one embryo. Although nuchal translucency was normal, the fetus seemed to have acrania and a large encephalocele of 15 x 12 mm (images 1, 2, 3, and 4). The parents were informed of the anomaly and chose interruption of pregnancy. An amniocentesis was performed just before. The karyotype was normal (46, XX), as was the AFP result. Pathophysiologic analysis was performed. The diagnosis w the entity was an interhemispheric arachnoid cyst
distending the cranium.患者，25岁，G1P0，孕13周时进行检查。既往病史无异常。超声检查发现为活胎并可见胎芽。尽管颈半透明度正常，但胎儿看上去像是颅骨缺失并且伴有明显的脑膨出，呈15×12mm（图1，2，3，4）。患者被告知胎儿异常并选择终止妊娠。就在次之前进行了羊膜穿刺术，显示核型正常（46，XX），AFP正常。进行了病理生理学分析，诊断不存在脑膨出，实际上是脑半球间的蛛网膜囊肿导致的颅骨膨大。Images 1, 2. (1) Pregnancy at 13 weeks GA with “cephalocele.” (2) Pregnancy at 13 weeks GA with abnormal skull, with “acrania and cephalocele.” 图1，2 （1）孕13周的“脑膨出”；（2）孕13周，颅骨异常合并“颅骨缺失和脑膨出”。 Images 3, 4. 3D views of fetus胎儿三维图像Images 5, 6. Postmortem view of the fetus.胎儿的尸解图像。
screen.width-333)this.width=screen.width-333" width=640 height=245 title="Click to view full 190.JPG (786 X 302)" border=0 align=absmiddle>Interhemispheric arachnoid cyst DefinitionArachnoid cysts are rare extraparenchymal congenital malformations. They are benign with a good prognosis if located near the Sylvian fissure and when they appear late in pregnancy.Arachnoid cysts are usually discovered at the end of the second trimester or during the third trimester. Diagnosis in the first trimester is possible, although exceptional and challenging. We report a case of a fetus with an arachnoid cyst discovered in the first trimester. Our initial diagnosis was encephalocele or acrania.Case reportWe present the case of a 25-year-old patient, G1P0, scanned at 13 weeks GA. Her medical history was noncontributive. On sonography we found a live singleton pregnancy. Although nuchal translucency was normal, the fetus seemed to have acrania and a large cephalocele of 15 x 12 mm (images 1, 2, 3, and 4). The parents were informed of the anomaly and chose interruption of pregnancy. An amniocentesis was performed just before. The karyotype was normal (46, XX), as was the AFP result. Pathophysiologic analysis was performed. The diagnosis the entity was an interhemispheric arachnoid cyst distending the cranium.HistoryIn 1984, Barth et al [2] researched world literature and found only four cases of interhemispheric arachnoid cysts described up to that time. In 1996, Hassan et al [8] described two cases of arachnoid cysts in the central fissure, one at 17 weeks GA and the second at 18 weeks GA.
In both cases, an interruption of pregnancy was performed. In the first case, isolated ventri in the second, absence of the aqueduct of Sylvius was noted.PrevalenceCerebral cysts (including arachnoid cysts) constitute 1% of intracranial masses in children. Two-thirds of these are subtentorial, one-third supratentorial. They are most often isolated and appear sporadically. In 2001, Pierre-Kahn et al [11] reported
a series of 54 fetuses with arachnoid cysts all diagnosed after 20 weeks GA. 55% of these cases were diagnosed between 20 and 30 weeks GA. Most arachnoid cysts are located in the Sylvian fissure. The literature shows that arachnoid cysts of the tentorial fissure or in the interhemispheric fissure are extremely rare.EtiologyArachnoid cysts may be primary arachnoid cysts are a
consequence of abnormal brain development. Causes of acquired arachnoid cysts are:HInfections suc orTrauma from ischemia or other damage due to the fragility of the arachnoid membrane.PathogenesisHistology of arachnoid cysts has the following distribution:90% are simply pure arachnoid membrane, located in the subarachnoid spaces. They have a peripheral location, usually in the Sylvian fissure. They most often remain latent.10% of arachnoid cysts are neuroepithelial, usually located in the subarachnoid space, but rarely in the ventricles or brain parenchyma. Their location is most often the median fissure, simulating an early hydrocephalus as was the case with our patient. The arachnoid membrane is particularly sensitive to trauma or inflammation, either of which can cause arachnoid cyst formation.
Developmental etiology of arachnoid cysts is not well known. It is likely that the appearance of arachnoid cysts involves compression of the aqueduct of Sylvius resulting in ventriculomegaly which then compromises cerebral parenchyma. Therefore the size, date of appearance, and the location of arachnoid cysts influence diagnosis and prognosis o first-trimester appearance of an arachnoid cyst usually yields a dire prognosis.Sonographic findingsThe first indication of an arachnoid cyst is often seen at the subtentorial level, where a hypoechogenic area, will be seen, avascular on Doppler interrogation. Arachnoid cysts may deform adjacent cerebral structures, as happened in our case. Their size can compress brain parenchyma, impeding circulation of cerebrospinal fluid in the aqueduct of Sylvius. It can cause ventriculomegaly, resulting in hydrocephalus with extreme dilatation or effacement of the third and fourth ventricles. The posterior fossa remains normal unless an arachnoid cyst is located in the cisterna magna.Implications for targeted examinationsArachnoid cysts only rarely appear in theoretically, they are an isolated, sporadic phenomenon. Nevertheless, sonography and amniocentesis are important to rule out other anomalies. Amniocentesis should be performed prophylactially upon discovery of an arachnoid cyst, but fetal karyotype in an isolated case of arachnoid cyst is normal. Interhemispheric arachnoid cysts are frequently associated with partial or total agenesis of the corpus callosum. This diagnosis is not possible in the first trimester, however, as the corpus callosum does not develop fully until 18 weeks GA. Small arachnoid cysts ar but large cysts display symptoms involving cerebral parenchymal compression and then hydrocephalus, as in our case.Differential diagnosisAE H Agenesis of the corpus callosuEnormous primVein of Galen aneurysm (usually undiscovered until the second trimester, though Doppler interrogation can assist in early diagnosis);Porencephaly (which appears in the third trimester); Septum pellucidum cysts (which also appear in the third trimester).During the first trimester, brain compression by a large arachnoid cyst may lead to hydrocephalus, which may regress, as in the case of Elbers, Furness, et al [6].PrognosisIsolated arachnoid cysts appearing in the third trimester have a good prognosis. However, early-appearing arachnoid cysts have a grave prognosis, and interruption of pregnancy is often proposed.ConclusionAlthough early-appearing arachnoid cysts carry a serious prognosis, the choice to interrupt pregnancy should be well considered, since rarely interhemispheric arachnoid cysts may regress as in the case cited above by Elbers [6]. Sonographers and clinicians should add arachnoid cysts to their differential diagnosis of intracranial cystic masses, especially since discovery of arachnoid cysts is increasingly possible at 11 to 14 weeks GA. Education about arachnoid cysts will help parents make an early and informed choice about pregnancy in case of discovery.稍等，正在翻译中...版主,请问您的资料是哪里下载的呀,您的资料都好新呀!定义：蛛网膜囊肿是一种少见的脑实质外的先天性异常，它属于良性病变，如果囊肿靠近大脑外侧裂并且在晚期妊娠时发生则预后良好。蛛网膜囊肿通常在妊娠中期末或晚期发现，早期妊娠时也可诊断，尽管很少发生并且也很难诊断。我们报道了一例在妊娠早期时发现的蛛网膜囊肿的胎儿，最初我们诊断为脑膨出或无颅畸形。历史：1984年，Barth等人分析了全世界范围内的文献资料，发现在此之前仅仅报道有4例半球间蛛网膜囊肿。1996年，Hassan等人报道了2例发生在大脑中央沟的蛛网膜囊肿，其中一例发生在妊娠17周，另一例为妊娠18周。这两个病例均终止了妊娠，第一例发现有孤立性巨脑室，另一例发现有中脑水管缺失。患病率：脑囊肿（包括蛛网膜囊肿）占儿童颅内肿块的1%，其中2/3位于幕下，1/3位于幕上，最常见于孤立性散在发生。2001年，Pierre-Kahn等人报道了一系列的54例蛛网膜囊肿的胎儿，均为妊娠20周后诊断。55%的病例在妊娠20周到30周间做出了诊断。大部分蛛网膜囊肿位于大脑外侧裂。文献显示侧副沟或半球间的蛛网膜囊肿极其罕见。病因学：蛛网膜囊肿可以是原发，也可继发。原发性蛛网膜囊肿是由于大脑发育异常导致，继发性蛛网膜囊肿的病因包括：●出血●感染，比如巨细胞病毒感染●局部缺血导致的损伤或者由于蛛网膜脆弱造成的其他损伤发病机理：蛛网膜囊肿的组织学有以下分类：90%的只是单纯的蛛网膜，位于蛛网膜下腔，囊肿属于外周部位，通常是在大脑外侧裂，最常见是潜在发生。10%的蛛网膜囊肿是神经上皮的，通常位于蛛网膜下腔，但很少位于脑室或脑实质内，最常见于中央沟，像是早期的脑积水，就像我们报道的这个病例一样。蛛网膜非常容易受伤或发生感染，这两种情况均能造成蛛网膜囊肿的形成。蛛网膜囊肿发生的病因并不很清楚。蛛网膜囊肿的发生可能会导致中脑水管受压造成脑室扩张，从而压迫脑实质。因此，蛛网膜囊肿的大小、出现的时期以及发生的部位会影响其诊断和患儿的预后。早期妊娠发现蛛网膜囊肿通常会导致不良预后。声像图表现：蛛网膜囊肿的最初表现是在幕下水平发现一低回声区，多普勒扫描无血流。蛛网膜囊肿能造成邻近脑结构变形，就像我们报道的这例。蛛网膜囊肿的大小能使脑实质受压导致中脑水管内的脑脊液循环受阻，使得脑室扩张，出现脑积水和第三脑室和第四脑室的极度扩张或消失。后颅窝可以正常，除非蛛网膜囊肿位于小脑延髓池。定向检查的意义：蛛网膜囊肿很少发生在早期妊娠，理论上说属于孤立性散在发生。然而，超声检查和羊膜穿刺术对于排除其他异常很重要。发现蛛网膜囊肿后应随即进行预防性的羊膜穿刺术，但孤立性的蛛网膜囊肿的胎儿核型可以是正常的。半球间蛛网膜囊肿常常合并胼胝体的部分或完全发育不全，这在妊娠早期诊断是不可能的，因为在妊娠18周之前胼胝体还未完全发育。小的蛛网膜囊肿常没有症状，但较大的囊肿因脑实质受压导致脑积水而表现症状，就像我们的这个病例。鉴别诊断：无颅畸形；脑膨出；前脑无裂畸形；胼胝体发育不全合并脑积水；巨大的原发性脑室扩张；Galen静脉瘤（通常在中期妊娠前不能发现，尽管多普勒倒霉能有助于早期诊断）；孔洞脑畸形（出现于晚期妊娠）；透明隔囊肿（也发生在晚期妊娠）。早期妊娠期间，脑组织受到较大蛛网膜囊肿的压迫会导致脑积水，但也可复原，Elbers、Furness等人就曾报道过这样的病例。预后：晚期妊娠出现的孤立性蛛网膜囊肿预后很好，而早期出现的蛛网膜囊肿预后不佳，经常要终止妊娠。结论：尽管早期发生蛛网膜囊肿的预后很差，但也应该慎重选择终止妊娠，因为根据Elbers的报道少见的半球间蛛网膜囊肿可以消退。超声工作者和临床医师应该在颅内的囊性肿块的鉴别诊断时应该考虑到蛛网膜囊肿，尤其是在妊娠11到14周发现蛛网膜囊肿的可能日渐增多。针对蛛网膜囊肿的培训有助于提早告知患病父母就妊娠做出选择。
您的位置： &&胎儿蛛网膜囊肿能治疗吗?
胎儿蛛网膜囊肿能治疗吗?
先天性蛛网膜囊肿是脑脊液被包围在蛛网膜内所形成的袋状结构。不与蛛网膜下腔相通。其确诊在胎儿时期最好的辅助检查为B超。目前建议您定期进行检查，明确是否快速增大，以及胎儿发育情况。一些囊肿终身无症状，也有囊肿自行消失的报道。一般脑囊肿的治疗在待胎儿出生后可视囊肿的发展情况择期治疗，但我们一般主张早期治疗。目前脑囊肿的治疗主要分为手术和传统的中医治疗为主。
能在母亲的肚子里面进行治疗吗?
待胎儿出生后可视囊肿的发展情况择期治疗，但我们一般主张早期治疗。目前脑囊肿的治疗主要分为手术和传统的中医治疗为主。
蛛网膜囊肿对胎儿有什么影响呢?可以选择终止妊娠吗?
临床表现与颅内占位病变相似。部分患者可有轻瘫或癫痫发作。还可有局部症状，如眼球突出和头部不称等。 可以选择终止妊娠
提问者 的感言：非常感谢.
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孕育指南领域专家