摘要
目的探讨后颅窝血管母细胞瘤（hemangioblastoma,HB）的磁共振（MRI）特征性表现以及手术治疗方法,提高对该病的诊断和显微外科手术治疗水平。方法回顾性分析我科2010年1月-2013年12月43例开颅经显微镜手术切除及病理证实的后颅窝HB资料。结果 37例囊壁小结节型肿瘤、4例实质型肿瘤、1例囊实型做到全切除,1例多发者靠近延髓HB未切除。术后1周头痛、头晕、恶心或呕吐等神经系统症状消失40例;1例遗有走路不稳;1例合并脑积水者术后第3天行侧脑室穿刺术,7天拔除脑室穿刺管,2周恢复正常出院;1例累及脑干者术后术腔出血,二次手术后第2天死亡。40例术后随访3个月-1年,平均11.5月,38例GOS评分5分（恢复正常生活）,1例4分（遗有行走不稳症状）,1例术后6个月复发并于术后15个月再次手术治疗。结论 MRI是术前诊断及鉴别诊断后颅窝HB的主要方法,明确诊断后尽早显微外科手术切除是后颅窝HB有效且安全的治疗方法。
Objective To discuss the characteristics of magnetic resonance imaging （MRI） and surgical treatment for posterior cranial fossa hemangioblastoma （HB）, and to improve the diagnosis and microsurgical treatment for the disease. Methods We retrospectively analyzed 43 cases treated by microsurgical resection of craniotomy and pathologically diagnosed as posterior cranial fossa hemangioblastoma in our department from January 2010 to December 2013. Results Total resection was obtained in 37 cases of cystic nodule hemangioblastoma, 4 cases of solid hemangioblastoma and 1 case of solid-cystic hemangioblastoma, while the lesion was not removed in 1 case of multiple hemangioblastoma close to the medulla. One week after operation, 40 patients＇ neurological symptoms of headache, dizziness, nausea or vomiting were relieved. Walking instability remained as preoperation in 1 case. One case of hydrocephalus was given a secondary lateral ventricle puncture three days after the first operation and then removed the ventricular drainage tube seven days after the second operation, and recovered 2 weeks later. One case of brain stem involvement was given a secondary operation because of hemorrhage in operation area and was dead one day after surgery. Forty patients were followed up for 3 months -1 year after surgery： GOS scores were 5 in 38 cases （recovery to normal） and 4 in 1 case （walking instability remained）. Recurrence happened in 1 case 6 months after operation, receiving a secondary surgery 15 months later. Conclusions MRI is the main method of preoperative diagnosis and differential diagnosis for posterior cranial fossa hemangioblastoma. Early microsurgical resection is effective and safe to treat the posterior cranial fossa hemangioblastoma.
出处
《中国微创外科杂志》
CSCD
北大核心
2015年第9期805-808,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
后颅窝
血管母细胞瘤
诊断
鉴别诊断
显微外科手术
Posterior cranial fossa
Hemangioblastoma
Diagnosis
Differential diagnosis
Microsurgical operation
