伽玛刀治疗下丘脑错构瘤(附10例分析)

Clinical analysis of hypothalamus hamartomas treated by gamma knife(report of 10 cases)

目的观察伽玛刀治疗下丘脑错构瘤的效果。方法回顾性分析近10年我院伽玛刀治疗的10例下丘脑错构瘤的临床资料。全部采用伽玛刀治疗,周边剂量10~17 Gy,平均13.3 Gy;等剂量曲线采用40%~55%。结果随访2~10年,平均7.3年。有癫痫表现的9例,Engel分级Ⅰ级3例,Ⅱ级4例,Ⅲ级1例,Ⅳ级1例,治疗有效率为88.89%。性早熟2例,伽玛刀治疗无效。无并发症。结论伽玛刀治疗是缓解下丘脑错构瘤癫痫症状的有效方法。

Objective To observe the therapeutic effect of gamma knife on hypothalamus hamartomas. Methods Of 10 patients （mean age, 14.3 years） treated in our hospital in the recent 10 years, 6 were females and 4 males. The course of disease ranged from 1 to 22 years （mean, 7.6 years）. Of the 10 patients, 8 had epilepsy, 1 sexual precocity and 1 sexual precocity and convulsive epilepsy. MRI showed that there was a mass with T1WI, T2WI equal signal over the interpeduncular cistern, the third ventricle or the pituitary stalk and the lesion was not enhanced. All the patients were treated with gamma knife. The marginal dose ranged from 10 to 17 Gy （mean, 13.3 Gy） and the prescription isodose was 40%-55%. Results All the patients were followed up from 2 to 17 years （mean, 7.3 years）. The curative effects on the epilepsy were assessed after the treatment in 9 patients with epilepsy according Engel grade. Of 9 patients, 3 belonged in grade Ⅰ, 4 in grade Ⅱ, 1 in grade Ⅲ, and 1 in grade Ⅳ. The effective （Engel gradesⅠ-Ⅲ） rate was 88.89% （8/9）. There was not significantly effect of gamma knife on the sexual precocity induced by hypothalamus hamartoma. No complications were found in all the patients. Conclusion Gamma knife is an effective method to treat epilepsy induced by hypothalamus hamartoma.