颅内脂肪瘤的诊断与治疗

Diagnosis and treatment of intracranial lipomas

目的探讨颅内脂肪瘤的诊断与治疗方法。方法分析10例颅内脂肪瘤的临床特点、神经放射学资料。对6例有症状者行手术治疗,其中胼胝体脂肪瘤1例行全切除术,2例行次全切除术,环池脂肪瘤和桥小脑角脂肪瘤各1例行部分切除术,四叠体板脂肪瘤并梗阻性脑积水1例行脑脊液分流术。结果术后除1例面肌痉挛和听力减退无变化外,其余各例的症状均缓解或明显改善。用 CT 或 MRI 随访5年,病灶无明显变化。结论CT 和 MRI 有助于确诊本病。对症状明显者行手术治疗,手术要点是适当地行显微外科减压或脑脊液分流。

Objective To explore the diagnosis and treatment for intracranial lipomas.Methods Clinical features and neuroradiolo- gical material of the 10 patients were studied.Surgical operations were performed in six patients with symptoms.Total removal of the tumor was performed in one and subtotal removal was perfomed in two patients with callosal lipomas,respectively.Partial re- moval was performed in an ambient cisten lipoma patient and in a cerebellopontine angle(CPA) lipooma patient.One patient with quadrigeminal plate lipoma complicated with hydrocephalus was treated by the insertion of cerebrospinal fluid shunt.Results The presenting neurological symptoms subsided except the CPA lipoma patient still having the hemifacial spasm and hearing loss un- changed.CT or MRI scan follow up showed no change in the size of the lipomas at a mean follow-up period of 5 years.Conclusion Computed tomographic and magnetic resonance are decisive exam tools for the diagnosis of intracranial lipoma.Surgical interven- tion is necessary if symptoms are getting worse progressively.The key points of operation are microsurgiea[ decompression and per- manent cerebrospinal fluid shunt.