延髓海绵状血管瘤18例分析

Cavernomas in the medulla oblongata:report of 18 cases

目的总结延髓海绵状血管瘤的治疗经验。方法回顾性分析18例延髓海绵状血管瘤的临床资料,术前KPS评分79.4±9.9。未行手术、仅常规对症处理4例;手术治疗14例,其中采用枕下后正中经小脑延髓裂入路13例,远外侧经髁入路1例。结果保守治疗4例;血管瘤全切除12例,近全切除2例。随访12例,时间1～91个月,包括手术治疗10例,术后KPS评分84.1±27.5,生活质量较术前明显改善7例,无变化2例,死亡1例;保守治疗2例,随访时间已达22个月,未见症状加重。结论对延髓海绵状血管瘤,应选择个体化治疗方案;手术治疗可取得较好预后。

Objective To summarize therapeutic strategies of medulla oblongata cavernomas （MOC）.Methods Clinical data of 18 patients with MOC were analyzed retrospectively.The preoperative KPS was 79.4 ± 9.9.No surgery and only symptomatic treatment was performed in 4 cases.14 patients underwent surgery via different approaches：posterior midline transcerebellomedullary fissure approach in 13 and far-lateral transcondylar approach in 1.Results Four patients were conservatively treated.Total resection was achieved in 12 cases,and near total resection in 2.A follow-up of 1 to 91 months was performed in 12 cases.10 received surgical treatment and postoperative KPS was 84.1 ± 27.5：improvement in 7,no changes in 2,death in 1.Two others received conservative treatment and follow-up period had reached 22 months without aggravation.Conclusions Individualization treatment should be chosen for MOC patients and surgical treatment could confer a favorable prognosis.