中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2009年
5期
436-439
,共4页
罗毅男%葛鹏飞%付双林%孟繁凯%孙利波%王海峰%李文臣%于天浩
囉毅男%葛鵬飛%付雙林%孟繁凱%孫利波%王海峰%李文臣%于天浩
라의남%갈붕비%부쌍림%맹번개%손리파%왕해봉%리문신%우천호
血管瘤,海绵状,中楸神经系统%脑干%显微外科手术
血管瘤,海綿狀,中楸神經繫統%腦榦%顯微外科手術
혈관류,해면상,중추신경계통%뇌간%현미외과수술
Hemangioma,cavernous,central nervous%Brain stem%Microsurgery
目的 探讨显微手术切除腩十海绵状血管瘤的时机、方法和预后.方法 回顾性分析显微手术切除及病理证实的10例脑干内海绵状血管瘤的临床资料.所有病例均行CT及MRI检查.海绵状血管瘤位丁中脑1例、桥脑7例、延髓2例.采用颞下入路切除中脑海绵状血管瘤1例;乙状窦后入路切除桥腑海绵状血管瘤3例;枕下中线经第四脑室入路切除延髓海绵状血管瘤2例、桥脑海绵状血管瘤4例.采用GOS分级对于术结果进行评估.结果 显微镜下将肿瘤全切,无手术死亡.10例患者均获得随访,随访时间3-48个月(平均18.5个月).术后3个月GOS分级:Ⅴ级5例,Ⅳ级5例;术后1年GOS分级:Ⅴ级8例,Ⅳ级2例.无再出血者.结论 显微外科手术是治疗脑干内海绵状血管瘤的有效方法,远期效果满意.
目的 探討顯微手術切除腩十海綿狀血管瘤的時機、方法和預後.方法 迴顧性分析顯微手術切除及病理證實的10例腦榦內海綿狀血管瘤的臨床資料.所有病例均行CT及MRI檢查.海綿狀血管瘤位丁中腦1例、橋腦7例、延髓2例.採用顳下入路切除中腦海綿狀血管瘤1例;乙狀竇後入路切除橋腑海綿狀血管瘤3例;枕下中線經第四腦室入路切除延髓海綿狀血管瘤2例、橋腦海綿狀血管瘤4例.採用GOS分級對于術結果進行評估.結果 顯微鏡下將腫瘤全切,無手術死亡.10例患者均穫得隨訪,隨訪時間3-48箇月(平均18.5箇月).術後3箇月GOS分級:Ⅴ級5例,Ⅳ級5例;術後1年GOS分級:Ⅴ級8例,Ⅳ級2例.無再齣血者.結論 顯微外科手術是治療腦榦內海綿狀血管瘤的有效方法,遠期效果滿意.
목적 탐토현미수술절제남십해면상혈관류적시궤、방법화예후.방법 회고성분석현미수술절제급병리증실적10례뇌간내해면상혈관류적림상자료.소유병례균행CT급MRI검사.해면상혈관류위정중뇌1례、교뇌7례、연수2례.채용섭하입로절제중뇌해면상혈관류1례;을상두후입로절제교부해면상혈관류3례;침하중선경제사뇌실입로절제연수해면상혈관류2례、교뇌해면상혈관류4례.채용GOS분급대우술결과진행평고.결과 현미경하장종류전절,무수술사망.10례환자균획득수방,수방시간3-48개월(평균18.5개월).술후3개월GOS분급:Ⅴ급5례,Ⅳ급5례;술후1년GOS분급:Ⅴ급8례,Ⅳ급2례.무재출혈자.결론 현미외과수술시치료뇌간내해면상혈관류적유효방법,원기효과만의.
Objective To investigate the mierosurgical time windows, techniques and prognosis of removing cavernous malformations in brain stem. Method The clinical materials of 10 cases of cavernous malformations of brain stem removed by microsurgery and demonstrated by pathological examinations were studied retrospectively. All the cases were examined preoperatively by cr and MRI. One lesion located in midbrain,7 lesions in pons and 2 lesions in medulla. The lesion in midhrain was removed by subtemporal approach,lesions in medulla and part of the lesion in pons were removed by subocciptal middle approach, and the other part of the lesions in pons were removed by retrosigmoid approach. GOS system was used to evaluate the prognosis. Results All the lesions were removed radically under microscope and no death arose. Pathological examination demonstrated all the lesions were cavernous malformations. All the cases were followed up from 3 months to 48 months with the average time 18. 5 months. 10 patients were evaluated by GOS system at 3 months after operation. There were 5 cases of GOS grade V and 5 cases of grade IV. 10 patients were evaluated by GOS system at 1 year after operation. There were 8 eases of GOS grade Ⅴ and 2 eases of grade Ⅳ. There was no bleeding after operations. Conclusions Microsurgery is an effective way to cure cavernous malformations in hrainstem, and the long-term prognosis is satisfying.