老年小脑毛细胞型星形细胞瘤伴卒中1例报告并文献复习

Cerebellar pilocytic astrocytomas with spontaneous intratumoral hemorrhage in elderly (a report of 1 case and review of literature)

目的探讨老年毛细胞型星形细胞瘤(pilocytic astrocytoma,PA)伴卒中的临床特点、手术方法及预后。方法回顾分析启东市中医院神经外科收治的1例老年小脑毛细胞型星形细胞瘤伴卒中患者的资料,并复习相关文献。手术采用后正中入路,显微镜下切除肿瘤并清除瘤内出血。结果患者表现突发头痛、呕吐伴视物模糊,行走不稳,向右侧倾斜。头颅MRI示右侧小脑半球及蚓部异常信号影。术后病理检查证实为毛细胞型星形细胞瘤(WHOⅠ级)。术后3个月复查MRI示肿瘤切除完全,无复发迹象。随访6个月,患者的症状均消失。结论老年毛细胞型星形细胞瘤伴出血病例非常少见,影像学检查是其主要诊断方法;显微镜下完整切除肿瘤并清除血肿,可获得良好的预后。

Objective To summarize the clinical characteristics,operative methods and prognosis of cerebellar pilocytic astrocytomas（PA） with spontaneous intratumoral hemorrhage in elderly. Methods The clinical data of an elder patient with PA with spontaneous intratumoral hemorrhage in the cerebellar was analyzed retrospectively. The resection of PA was performed by the posterior midline approach with microsurgical technique. The hemorrhage was alsototally resected. Results PA was confirmed pathologically. Postoperative MRI showed the tumor was completely removed. The follow-up of 6 months showed , the patient recovered well and no signs of recurrence were observed. Conclusions Cerebellar PA with spontaneous intratumoral hemorrhage in elderly is rare, MRI is the main examination method. Completely resecting the tumor and removing hemorrhage with microsurgical technique can obtain a good prognosis.