CAJ | 학술논문

目的探讨幕上表现于癫痫的颅内海绵状血管瘤外科治疗方法和效果.方法 25例幕上表现于癫痫的颅内海绵状血管瘤患者,根据术前影像学、脑电图表现与运动区的关系分为A、B二组.手术在皮层脑电图(ECoG)监测下进行,包括单纯切除血管瘤、切除血管瘤和切除含铁血黄素层,以及辅助部分皮层痫灶切除、皮层热灼或软膜下横切等.结果本组海绵状血管瘤均令切除,2例术后有一过性轻度肢体功能障碍,无手术死亡.随访10个月-4.5年,A组9例,Engel Ⅰ级6例;Engel Ⅱ B级2例;Engel Ⅲ级1例.B组16例,均无发作.结论幕上与癫痫有关的海绵状血管瘤在ECoG监测下做病灶和痫灶切除,是控制术后癫痫发作的有效手段;运动区和附近海绵状血管瘤由于手术没有完全切除致痫灶可能是术后癫痫控制率差的原因.
목적 탐토막상표현우전간적로내해면상혈관류외과치료방법화효과.방법 25례막상표현우전간적로내해면상혈관류환자,근거술전영상학、뇌전도표현여운동구적관계분위A、B이조.수술재피층뇌전도(ECoG)감측하진행,포괄단순절제혈관류、절제혈관류화절제함철혈황소층,이급보조부분피층간조절제、피층열작혹연막하횡절등.결과 본조해면상혈관류균령절제,2례술후유일과성경도지체공능장애,무수술사망.수방10개월-4.5년,A조9례,Engel Ⅰ급6례;Engel Ⅱ B급2례;Engel Ⅲ급1례.B조16례,균무발작.결론 막상여전간유관적해면상혈관류재ECoG감측하주병조화간조절제,시공제술후전간발작적유효수단;운동구화부근해면상혈관류유우수술몰유완전절제치간조가능시술후전간공제솔차적원인.
Objective To study the methods and outcomes of microsurgical treatment of supratentorial intracranial cavernous malformation associated with epilepsy.Methods From January 1998 to June 2005,25 cases presented with seizures associated one or more supratentorial cavernomas were selected to be reviewed retrospectively.Patients were divided into two groups according to EEG and radiological results.Group A:patients presented with epilepsy located in or near area motoria;group B:patients had epilepsy located away from area motoria.ECoG was used during surgery.No more sharp wave and spike Wave was observed in 5 patients after their cavernomas had been resected.In 7 patients,the cavernomas and surrounding hemosiderin.stained brain tissue were all reseeted.In the other 13 patients,we had to perform partial cortex lesionectomy,surface bipolar-coagulation,or multiple subpiM transaction.Brain Lab neuronavigation was applied in 12 patients with deep lesions.Results Total resection Was achieved in all patients.No one died.During the follow-up period(10-54 months),there were 6 cases of Engel Ⅰ,2 cases of Engel Ⅱ B and 1 case of Engel Ⅲ in group A(9 cases).There were 13 cases of Engel Ⅰ A and 3 cases of Engel Ⅰ B in group B(16 patients).Conclusion Resection of cavernoma and perilesional epileptic tissue under ECoG monitoring is saie and effective for seizure control of supratentorial cavernoma patirnts.Incomplete resection of cavernomas near the area motoria was the main reason of unsatisfactory seizure control.