颅内海绵状血管瘤的诊断与治疗

Diagnosis and Treatment of Intracranial Cavernous Hemangioma

目的 探讨颅内海绵状血管瘤的诊断和手术治疗方法。方法 回顾我院经手术证实的16例病人的临床资料,对其临床特征、诊断和治疗经验进行总结。结果 按发生部位将肿瘤分为三种类型:大脑半球型,颅中窝型,小脑型。大脑半球型9例,主要表现癫痫发作;颅中窝型5例,主要表现为视力野损害和眼球活动障碍;小脑型2例,表现为头痛和呕吐。肿瘤CT表现为圆形或类圆形的血供丰富的占位病变,但血管造影很少发现其血供。MR检查有助于明确诊断。肿瘤位于大脑半球和小脑者均全部切除,术后症状消失者占90％,颅中窝肿瘤全切除1例,部分切除4例,术后症状改善仅1例。结论 颅内不同部位海绵状血管瘤有各自的临床特点,诊断必须依靠MR检查,对有症状者应积极手术治疗。

Objective To investigate the diagnosis and treatment of patients with intracranial cavernous hemangioma. Method Clinical data obtained from 16 cases of intracranial cavernous hemangiomas were analyzed and summarized. Results The tumors were divided into three types: (1)Hemisphere type, 9 patients, their chief complaints were epilepsy; (2) Middle cranial fossa type, 5 patients, their chief complaints were impairment of vision and abnormal movement of eyeball; (3)Cerebellum type, 2 patients, their complaints were headache and vomiting. CT scans showed the tumors were round or nearly round masses with high blood supply, but on angiogram examination the tumor's blood supply was hardly found. MR was helpful to make a correct diagnosis . The tumors located in the hemisphere and cerebellum were totally removed by surgery and 90% of the symptoms disappeared postoperatively. Among the pationts with the middle cranial fossa type, there was only one patient whose tumor was totally resected. Conclusions Intracranial cavernous hemangiomas have their own distinct clinical characteristics, which related to their different locations . Establishment of diagnosis mainly rely upon the MR fidings. Surgical treatment is suitable for those with symptoms.