血管成像的隐性海绵状血管瘤并发脑实质出血15例

Angiographically occult cavernous angioma combined with intracerebral hemorrhage in 15 cases

目的 观察手术治疗15例血管成像隐性海绵状血管瘤引起颅内出血的临床效果。方法 15例复发性脑出血患者经CT／MRI证实。全部患者均采用显微手术治疗,12例只采用病变切除,1例病变在桥脑经第四脑室基底入路并经面神经上三角切除了海绵状血管瘤,2例颞叶海绵状血管瘤有顽固癫痫,做颞叶及病灶切除。所有手术标本均经病理证实为海绵状血管瘤。 结果 15例全部切除了病变,获得良好的效果,组织病理学证实为海绵状血管瘤。结论 手术有效而安全,即使在脑功能区也能获得优良效果。

Objective The authors reviewed the experience of surgical treatment for 15 patients with angiographically occult cavernous angioma causing intracerebral hemorrahge. Methods 15 patients with recurrent intracerebral hemorrhage confirmed by CT or MRI from Jan. 2001-Jan. 2003 were studied retrospectively. All patients presented a new neurological deficit, or onset of acute headache. Persistent neurological deficits correlated with the number of recurrent hemorrhages and their locations. All patients were treated by microsurgery. 12 cases adopted only lesions resection. 1 case of lesion in pons was treated through the Ⅳ ventrical base approach and through superior triangle of facial nerve to remove the cavernoma. 2 Cases suffered from intractable epilepsy with cavernoma in temporal lobe were treated with lesions resection and temporal lobectomy. All surgical samples were demonstrated by pathology as cavernoma. Results Fifteen patients underwent surgery with total excision of the lesions and got favorable results. Histopathological review confirmed the excised lesions to be cavernous angioma. Conclusion Surgery can be effective and relatively safe to remove cavernoma even in the functional area of the brain.