经胼胝体穹隆间入路切除下丘脑内型错构瘤

Transcallosal-interfornix approach to remove the intrahypothalamic hamartomas

目的探讨下丘脑内型错构瘤的手术治疗方法。方法报告4例下丘脑内型错构瘤,采用右额后开颅经胼胝体-透明隔-穹隆间入路切除下丘脑内型错构瘤。结果4例均为儿童,男女为31,均以癫痫发作为主要症状,错构瘤为大部切除或部分切除,术后低钠血症1例,轻度尿崩1例,无其他合并症。随诊半年至1.5年,无任何癫痫发作。结论经胼胝体-透明膈-穹隆间入路是下丘脑内型错构瘤的最佳手术入路,错构瘤大部切除或部分切除即可取得满意疗效。

Objective To discuss the surgical approach to the intrahypothalamic hamartomas. Methods We reported 4 cases of intrahypothalamic hamartomas removed via transcallosal-interfornix approach. Results All of the 4 children (3 boys and 1 girl) presented with epilepsy and their hamartomas were gross partially or partially removed. There were no postoperative complications except one child presented with hyponatremia and another child with transient diabetes insipidus. All the four children were seizure-free during the followe-up period from 0.5 to 1.5 years. Conclusions The best surgical approach to the intrahypothalamic hamartomas is transcallosal-interfornix approach and the gross partially or partially removed of hypothalamic hamartoma can also induce a good result.