小脑血管母细胞瘤的诊断和显微外科治疗

Diagnosis and microsurgical treatment of cerebellum hemangioblastoma

目的:探讨小脑血管母细胞瘤的诊断及显微手术的处理要点。方法:回顾性分析经手术和病理证实的20例小脑血管母细胞瘤。结果:发病年龄为20～57岁,男性多于女性,临床表现以头痛和共济失调为主,CT和MRI是主要的诊断方法。肿瘤位于小脑半球18例,小脑蚓部2例,囊性18例,实质性2例。治疗行瘤结节及实性肿瘤全切除16例,部分切除加放射治疗4例。20例术后恢复良好,无死亡病例。结论:CT和MRI可以对小脑血管母细胞瘤作出定性、定位诊断,并可将其分型以利于选择不同的手术方法。该肿瘤为良性肿瘤,治疗首选手术切除,术后肿瘤残余可行放疗或γ刀治疗,预后良好。

Objective To study the diagnosis and microsurgical warning events of cerebellum hemangioblastoma.Method The data of 20 cases with cerebellum hemangioblastoma which was pathologically confimed were analyzed retrospectively.Results The tumor occurred mainly in the patients aged from 20～57 years and was more seen in men than in women.The most common presenting symptoms were headache and ataxia.CT and MRI were major diagnostic modalities.Tumors located on cerebellar hemisphere 18 cases,cerebellar vermis 2 cases.Tumors were cyst in 18 cases and soli in 2 cases.The tumor node and solid tumor were completely resected in 16 cases and 4 patients underwent the subtotal removal in addition to radiotherapy.After operation,20 cases recovered well and no died.Conclusion CT and MRI can make out the diagosis of localization and the nature and classification.The classification is conductive to selecting appropriate operative method.The tumor is benign tumor and surgical operation should be recommended.Good prognosis can be achieved with the radioneurosurgery or γ-knife treatment after operation.