显微手术治疗小脑海绵状血管瘤

Microsurgical treatment of cerebellar cavernous angioma

目的总结小脑海绵状血管瘤的临床表现及手术治疗效果。方法对12例均经手术切除和病理证实的小脑海绵状血管瘤进行回顾性分析。结果 11例急性起病,表现为小脑自发性出血。慢性起病1例,表现为渐进性共济失调、行走不稳。头颅MRI平扫与增强多表现为T1高信号,T2高或混杂信号,病灶周围有环形低信号带。磁敏感加权成像序列(SWI)更有助于诊断。12例均采用显微手术治疗,所有病灶均完整切除,疗效满意。结论自发性出血是本病的主要症状,多有共济失调等小脑受损体征。MRI具有较高的诊断特异性,手术是处理小脑海绵状血管瘤安全和有效的首选方法。

Objective To investigate the clinical presentation and surgical results of cerebellar cavernous angiomas. Methods A total of 12 cases with cerebellar cavernous angiomas confirmed by pathology and operation were analyzed retrospectively. Results Eleven patients had acute onset with the symptom of cerebellum hemorrhage and 1 case had chronic onset presenting with the progressive ataxia. T1 WI showed hyper-intense signal in 7 cases; T2 WI showed non-homogeneous hyper- and mixed-intense signal with a surrounding hypo- intense tim. Susceptibility-weighted imaging （SWI） increased the diagnostic specificity and sensitivity of eerebellar cavernous angioma. Conclusion Spontaneous hemorrhage is the main symptom of cerebellar cavernous angioma,which usually is accompanied by the signs of cerebellum damage such as ataxia. As a method of diagnosis, MRI is highly specific and sensitive and microsurgical treatment is a safe and effective option for cerebellar cavernous angioma.