影像导向立体定向开颅切除颅内病灶(12年临床经验总结)

Image-guided stereotactic craniotomy for brain lesions: experiences of twelve years

目的探讨影像导向立体定向开颅切除颅内病灶的手术方法和术式特点。方法回顾性总结1991年5月～2003年5月完成的立体定向开颅术442例,病灶位于额叶225例,颞叶48例,顶叶96,枕叶33例,多发病灶40例。其中154例位于脑重要功能区。结果均成功切除病灶。术后一过性运动、语言、感觉障碍加重23例,癫发作3例,遗留永久性功能障碍2例。结论立体定向开颅术是一种定位精确、侵袭性小的手术方式,适用于功能区或皮质下病灶(直径≤5cm)的切除。

Objective To study the surgical procedures and characteristics of stereotactc craniotomy. Methods 442 cases of undergone image-guided stereotactic craniotomy from May 1991 to May 2003 were analyzed retrospectively. The lesions were located in frontal lobe in 225, temporal lobe in 48, parietal lobe in 96, occipital lobe in 33, and multiple in 40 patients. Among them there were 154 cases of lesions involved to the eloquent area. Results Total removal of the lesions was made in all cases. Postoperative temporarily neurological deficits including aphasia, motorola and sensory disturbance presented in 21 patients, seizure in 3 patients, and permanent deficit in 2. Conclusion Image-guided stereotactic craniotomy is an accurate, minimally invasive surgical procedure for brain lesions. It is suitable to resect the lesions involved to the eloquent area and subcortical lesions which diameter is no more than 5cm.