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Diagnosis and surgical treatment of brainstem hemangioblastomas
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF NEUROSURGERY
- Issue:
- 2
- DOI:
- 10.3760/j.issn:1001-2346.2004.02.013
- Key Word:
- 血管母细胞瘤;脑干;诊断外科
Abstract： 目的探讨脑干血管母细胞瘤(BSHs)的诊断和治疗的进展.方法回顾性分析经外科手术和病理证实、不伴Von Hippel-Lindau病的单发BSHs.结果33例BSHs占同期单发颅内血管母细胞瘤的15.5%.男性17例,女性16例,平均年龄45岁.临床表现缺乏特征性,MRI和DSA是主要诊断方法.肿瘤位于延脑14例、桥延脑9例、桥脑6例和延颈髓4例.实质性29例,囊性4例.脑干外型25例,脑干内型8例.小型(≤3cm)5例、大型(3.1～4cm)19例和巨型(＞4cm)9例.术前供血动脉栓塞12例.10例亚低温伴/不伴降压麻醉.肿瘤全切31例(94%),不全切2例(6%).手术死亡2例(6%),均为外生型和实质性肿瘤.31例病人平均随访5年,KPS≥80分25例(80.6%),60～70分4例(12.9%),40～50分2例(6.5%).结论BSHs多为实质性,可分脑干内型和脑干外型.囊性脑干内型术后疗效优.巨大型实质性BSHs仍然是处理难题.术前供血动脉栓塞,亚低温降压麻醉、显微外科技术和围手术期心肺精心处理等综合措施可提高手术疗效.
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