CAJ | 학술논문

目的探讨岛叶海绵状血管畸形(CMs)手术治疗方法与效果.方法回顾性分析2007年12月至2013年8月手术治疗的4例岛叶CMs患者,采用术中B超(2例联合神经导航)辅助下经侧裂入路切除岛叶CMs,分析手术策略及术后神经功能状态.结果 4例岛叶CMs患者,均以癫痫发作为首发症状,经侧裂-经岛叶入路完整切除CMs.术后随访3～ 72个月(平均36.75个月),1例患者术后神经学恶化,永久神经学缺陷;1例出现语言缺陷,1周后逐渐恢复.Engel疗效分级,4例患者癫痫预后均为Ⅰ级.结论经侧裂入路可安全可靠的暴露并切除岛叶CMs;神经导航、术中B超可为成功切除岛叶CMs提供指导.
목적 탐토도협해면상혈관기형(CMs)수술치료방법여효과.방법 회고성분석2007년12월지2013년8월수술치료적4례도협CMs환자,채용술중B초(2례연합신경도항)보조하경측렬입로절제도협CMs,분석수술책략급술후신경공능상태.결과 4례도협CMs환자,균이전간발작위수발증상,경측렬-경도협입로완정절제CMs.술후수방3～ 72개월(평균36.75개월),1례환자술후신경학악화,영구신경학결함;1례출현어언결함,1주후축점회복.Engel료효분급,4례환자전간예후균위Ⅰ급.결론 경측렬입로가안전가고적폭로병절제도협CMs;신경도항、술중B초가위성공절제도협CMs제공지도.
Objective To explore the surgical strategy for insular cavernous malformations (CMs).Methods Between Dec.2007 and Aug.2013,4 patients with insular CMs were treated surgically through transsylvian approach by using image guidance system (neuronavigation in two cases,ultrasound in four cases).Results The seizure was the initial symptom in 4 patients with insular CMs.The image guidance system provided high-quality intraoperative imaging and guided the perfect operative approach of insular cortex dissection.All CMs were completely removed via transsylvian-transinsular approach.The mean follow-up period was 36.75 months (ranged from 3 to 72 months).Permanent neurologic morbidity after surgery was observed in 1 patient.One patient with dominant hemisphere lesion had temporary dysphonia,and the language function was recovered after 1 week.4 patients were Engel class Ⅰ.Conclusions Surgical resection of insular CMs through transsylvian approach was safe.Neuronavigation and intraoperative ultrasound were recommended,especially for patients whose lesion was located in the dominant hemisphere.