显微神经外科手术治疗中脑海绵状血管畸形(附11例报告)

Microsurgical treatment of midbrain cavernous malformation( the report of 11 cases)

目的探讨中脑海绵状血管畸形的临床特征、影像学特点、手术时机及手术入路的选择。方法回顾性分析11例中脑海绵状血管畸形患者的病例资料,病变均行手术切除,7例采用颞下经小脑幕入路,4例采用枕下经小脑幕入路(Poppen入路)。结果 11例患者中9例病变全切除,2例近全切除。9例患者获得随访,平均随访46个月,6例患者生活质量较术前明显改善,生活能自理,2例患者术后再出血,死亡1例。结论中脑海绵状血管畸形手术效果尚可,针对不同患者应选择个性化治疗方案,应掌握好手术时机,选择合适的手术方式。

Objective To investigate the clinical characteristics, imaging features, operation time and surgical ap-proach of midbrain cavernous malformation. Method The clinical data of 11 patients with midbrain cavernous mal-formation was retrospectively reviewed. All the patients were underwent surgical removal of the midbrain cavernous malformation. The lesions were removed via subtemporal-transtentorial（7 cases）,occipital transtentorial approach（4 cases） . Result Complete resection of cavernous malformation was achieved in 9 patients and subtotal removal in 2 patients. 9 patients were followed up and the mean follow-up time was 46 months. The quality of life in 6 patients showed significantly improvement than preoperative. Postoperative rebleeding was observed in 2 patients and 1 pa-tient died. Conclusion The clinical outcome of microsurgery for midbrain cavernous malformation is satisfactory. The individualized therapeutic strategies should be selected for midbrain cavernous malformation. The appropriate opera-tion time and correct surgical approach are recommended for patients with favorable outcome.