超选择颈内动脉卡氮芥化疗致脑组织坏死

CEREBRAL NECROSIS CAUSED BY SUPERSELECTIVE INTRAARTERIALCARMUSTINE CHEMOTHERAPY

目的：提高对恶性胶质瘤术后颈内动脉超选择化疗致脑组织坏死的认识。方法：对１９９２～１９９４年１８例颈内动脉或颈内动脉超选择卡氮芥（ＢＣＮＵ）化疗中，出现的４例局限性脑组织坏死的病理机制、临床和影像学表现以及治疗进行分析。结果：局限性脑组织坏死为ＢＣＮＵ的血管毒性和神经毒性造成，与给药途径有关。其临床及影像学表现与肿瘤复发相似，鉴别诊断困难，有颅压高症状时，手术是必要的。结论：当胶质瘤病人经过化疗和放疗的综合治疗后。

ABSTRACT Objective: To increase the knowlege of cerebral necrosis caused by intraarterial carmustine (BCNU) chemotherapy for the malignant glioma. Methods: The pathological mechanism、 clinical and photographic manifestations and treatments of the cerebral necrosis in 4/18 patients receiving intraarterial BCNU chemotherapy for malignant gliomas in 1992-1994 were analysed and introduced. Results: The focal cerebral necrosis resulted from the BCNU toxicity of the blood vessels and cerebral nerves, and it is related to the way of infusion and drug quantities. Due to the similar manifestations, it is difficult to differentiate and diagnose the cerebral necrosis from the recurrent gliomas. Conclusion: Focal cerebral necrosis should be considered when patients deteriorates with the symptoms and signs similar to the recurrent tumor after both the chemotherapy and radiation therapy. Timely and effective treatment should be given to them.