解放军医学杂志2012，Vol.37Issue(8)：800-804,5.
脑干海绵状血管瘤的显微手术治疗(附41例报告)
Microsurgical removal of brainstem cavernoma: A report of 42 cases
张剑宁 1刘锐 1尹丰 1田增民 1王亚明 1程岗 1李志超 1于新 1王洪伟 1赵全军 1赵虎林 1卢旺盛1
作者信息
摘要
Abstract
Objective To summarize the clinical features and the surgical approach and techniques for microsurgical removal of brainstem cavernoma, and to evaluate the efficacy of surgical treatment of brainstem cavernoma. Methods The clinical data of 41 brainstem cavernoma patients treated by microsurgical resection from January 2003 to April 2011 were retrospectively analyzed, and they were 23 males and 18 females, aged 8 to 62 years. The clinical presentations included signs and symptoms of increased intracranial pressure, such as headache and dizziness, long-tract signs such as cranial nerve dysfunction, numbness and decrease in muscle strength, and ataxia, According to the site of the lesions, surgical approaches were selected following the principle of "the shortest distance between the incision and the lesion". Intraoperative short-latency somatosensory evoked potential (SSEP) and auditory evoked potential (AEP) were monitored. Results Total resection of cavernoma was achieved in 35 patients, small residual tumor was left in 6 with giant lesions. No death occurred. Twenty-seven patients showed improvement in nerve function. Aggravation of preexisting neurological disorders or appearance of new neurological disorders was found in 14 patients, including 2 with respiratory dysfunction who regained spontaneous breathing after assisted respiration for one week. Follow-up was carried out for 38 months in average, Neurological deficits have been restored in most patients, and no recurrence was found except for 1 case of re-bleeding from residual tumor. Conclusions According to the lesion site and protruding direction, individualized surgical approach can be selected following the "shortest distance" principle for the resection of brainstem cavernoma. The application of intraoperative navigation and electrophysiologicai monitoring of the brainstem is helpful in reducing surgical injury and decreasing the complications.关键词
脑干/血管瘤,海绵状,中枢神经系统/显微外科手术Key words
brain stem/ hemangioma, cavernous, central nervous system/ microsurgery分类
医药卫生引用本文复制引用
张剑宁,刘锐,尹丰,田增民,王亚明,程岗,李志超,于新,王洪伟,赵全军,赵虎林,卢旺盛..脑干海绵状血管瘤的显微手术治疗(附41例报告)[J].解放军医学杂志,2012,37(8):800-804,5.
