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Atypical presentation of a posterior fossa tumour:A case report
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作者 Alisha Narotam Mikara Archary +2 位作者 Poobalan Naidoo Yeshkhir Naidoo Vanesha Naidu 《World Journal of Clinical Cases》 SCIE 2024年第13期2281-2285,共5页
BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress.This is of interest as the pa... BACKGROUND We described a case of a patient with a meningioma in the posterior fossa presenting atypically with an isolated unilateral vocal cord palsy causing severe respiratory distress.This is of interest as the patient had no other symptomatology,especially given the size of the mass,which would typically cause a pressure effect leading to neurological and auditory symptoms.CASE SUMMARY This case report described a 48-year-old male who was married with two children and employed as a car guard.He had a medical history of asthma for the past 10 years controlled with an as-needed beta 2 agonist metered dose inhaler.He initially presented to our facility with severe respiratory distress.He reported a 1-wk history of shortness of breath and wheezing that was not relieved by his bronchodilator.He had no constitutional symptoms or impairment of hearing.On clinical examination,the patient’s chest was“silent.”Our initial assessment was status asthmaticus with type 2 respiratory failure,based on the history of asthma,a“silent chest,”and the arterial blood gas results.CONCLUSION A posterior fossa meningioma of such a large size and with extensive infiltration rarely presents with an isolated unilateral vocal cord palsy.The patient’s chief presenting feature was severe respiratory distress,which combined with his background medical history of asthma,was misleading.Clinicians should thus consider meningioma as a differential diagnosis for a unilateral vocal cord palsy even without audiology involvement. 展开更多
关键词 Respiratory distress MENINGIOMA Unilateral vocal cord palsy posterior fossa tumour NEUROSURGERY NEUROLOGY Radiology Case report
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Treatment implications of posterior fossa ependymoma subgroups 被引量:1
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作者 Vijay Ramaswamy Michael D.Taylor 《Chinese Journal of Cancer》 SCIE CAS CSCD 2016年第11期563-566,共4页
Posterior fossa ependymoma comprises two distinct molecular entities,ependymoma_posterior fossa A(EPN_PFA)and ependymoma_posterior fossa B(EPN_PFB),with differentiable gene expression profiles.As yet,the response of t... Posterior fossa ependymoma comprises two distinct molecular entities,ependymoma_posterior fossa A(EPN_PFA)and ependymoma_posterior fossa B(EPN_PFB),with differentiable gene expression profiles.As yet,the response of the two entities to treatment is unclear.To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment,we studied a cohort of 820 patients with molecularly profiled,clinically annotated posterior fossa ependymomas.We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA,which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era:a retrospective multicohort analysis" in the Journal ofClinical Oncology.Patients with incompletely resected EPN_PFA tumors had a very poor outcome despite receiving adjuvant radiation therapy,whereas a substantial proportion of patients with EPN_PFB tumors can be cured with surgery alone. 展开更多
关键词 posterior fossa ependymoma GENOMICS Radiation PFA
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Concurrent chemotherapy and reduced - dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average - risk medulloblastoma: efficacy and patterns of failure 被引量:2
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作者 Douglas JG Barker JL +1 位作者 Ellenbogen RG Geyer JR 《中国神经肿瘤杂志》 2004年第1期46-46,共1页
PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS ... PURPOSE:To review the efficacy and patterns of failure in average-risk medulloblastoma patients treated withconcurrent chemotherapy and reduced-dose cranial spinal irradiation and a conformal tumor bed boost.METH-ODS AND MATERIALS:Thirty-three patients with average risk(defined as<==1.5 cm(2)of residual tumorafter resection,age>3 years,and no involvement of the cerebrospinal fluid or spine)medulloblastoma werediagnosed at our institution between January 1994 and December 2001.They were enrolled in an institutional 展开更多
关键词 dose cranial spinal irradiation followed by conformal posterior fossa tumor bed boost for average efficacy and patterns of failure risk medulloblastoma Concurrent chemotherapy and reduced
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Ondine's curse after posterior fossa decompression: report of one case 被引量:1
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作者 徐伦山 许民辉 《Journal of Medical Colleges of PLA(China)》 CAS 2001年第1期36-37,共2页
Objective and Methods: A case of Ondine’s curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and ... Objective and Methods: A case of Ondine’s curse after posterior fossa decompression was reported. A 33-year-old woman was admitted complaining 2 years of dizziness and progressive worsening of gait disturbances, and 1 year of repetitively ictal nausea. The diagnosis of Arnold-Chiari malformations was established. Results: The patient underwent suboccipital craniectomy and C1-3 laminectomy. In addition to this decompression measure, a fascial graft was sutured between the edges of the dural incision. Postoperatively, the patient lost automatic control of her respiration doting sleep and became hypercapnic and hypoxemic. Assisted ventilation was initiated. Conclusion: Ondine’s curse is possibly due to insensitivity of central chemoreceptors to carbon dioxide resulting in defective control of minute ventilation. Propofol is not recommended in eases of Ondine’s curse, and assisted ventilation until the restoration of automatic control of respiration can be of value. Oxygen inspiration alone is rather harmful than beneficial. 展开更多
关键词 翁丹氏呼吸困扰 病例 诊断 治疗 血氧不足
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Extrapineal mature teratoma of the posterior fossa in a child
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作者 Mónica Rivero-Garvía Javier Márquez-Rivas +1 位作者 Eloy Rivas Ana Belén Rueda-Torres 《Open Journal of Pediatrics》 2012年第3期257-259,共3页
Introduction: teratomas are non-malignantgerm cell tumors commonly composed of cell types derived from all of the three germ layers. Intracerebral teratomas typically are midline or paraxial lesions located in the pit... Introduction: teratomas are non-malignantgerm cell tumors commonly composed of cell types derived from all of the three germ layers. Intracerebral teratomas typically are midline or paraxial lesions located in the pituitary stalk or the pineal region. We report our experience with mature teratomas of the posterior fossa. Case report: we present the case of an 11-year-old caucasian female with progressive headache that caused interrupted sleep. Cerebral magnetic resonance imaging showed a midline lesion in the posterior fossa with mass effect and without contrast enhancement. Anatomic pathology revealed a mature teratoma. Conclusion: differential diagnosis of midline lesions in pediatric patients must include teratomas in spite of being posterior fossa lesions. 展开更多
关键词 MATURE TERATOMA posterior fossa CHILD GROSS TOTAL Reseccion Extrapineal
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Decompressive Craniectomy in Posterior Fossa Ischemic Stroke
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作者 Luciano Santana-Cabrera Guillermo Pérez-Acosta +2 位作者 Cristina Rodríguez-Escot Rosa Lorenzo-Torrent Manuel Sánchez-Palacios 《International Journal of Clinical Medicine》 2012年第4期302-303,共2页
Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy sea... Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional edema, and a posterior fossa decompressive craniectomy (DC) was carried out. 展开更多
关键词 Decompressive CRANIECTOMY posterior fossa Suboccipital CRANIECTOMY VERTEBROBASILAR INSUFFICIENCY
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Duration of Preoperative External Ventricular Drain in Pediatric Posterior Fossa Tumors—Does It Matter?
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作者 Ehtesham Ghani Ayman AlBanyan +1 位作者 Abdulrahman Sabbagh Maqsood Ahmad 《Open Journal of Pediatrics》 2017年第2期86-97,共12页
Objective: Aim of the study was to assess the duration of preoperative external ventricular drain (EVD) as a predictor for permanent cerebrospinal fluid (CSF) diversion in pediatric posterior fossa tumors. Methods: Th... Objective: Aim of the study was to assess the duration of preoperative external ventricular drain (EVD) as a predictor for permanent cerebrospinal fluid (CSF) diversion in pediatric posterior fossa tumors. Methods: The study was conducted in the Department of Pediatric Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia from January 2010 to December 2013. The data were collected retrospectively. The patients who had emergency insertion of external ventricular drain (EVD) due to hydrocephalus before the definitive posterior fossa tumor surgery were included in the study. Results: The preoperative emergency insertion of EVD was done in 38 patients with pediatric posterior fossa tumors. The patients were divided into two groups. Group A consists of those patients who had duration of preoperative EVD equal or less than 7 days. Group B includes those patients who had duration of preoperative EVD more than 7 days. Group A has 16 patients while Group B has 22 patients. The predominant clinical feature was symptoms and signs of raised intracranial pressure (ICP) only. Infection related to EVD was seen in seven patients. Ventriculoperitoneal (VP) shunt was required in 31.25% of Group A patients and 18.18% of Group B patients (p value = 0.35). Overall shunt rate was 23.68%. Conclusion: There are well known number of factors that can determine the need of permanent CSF diversion in patients with posterior fossa tumors. However, there is no effect of preoperative duration of EVD in determining the requirement of postoperative VP shunt. 展开更多
关键词 posterior fossa Tumors External VENTRICULAR Drain HYDROCEPHALUS Ventriculoperitoneal SHUNT CSF DIVERSION
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Venous Air Embolism Following the Use of Hydrogen Peroxide during Posterior Fossa Surgery in the Sitting Position
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作者 Zhen-dong Xu Wei-min Liang 《麻醉与监护论坛》 2012年第5期377-379,共3页
关键词 过氧化氢 手术过程 栓塞 空气 静脉 手术治疗 外科病 VAE
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Diagnosis and surgical treatment of posterior fossa solid hemangioblastomas 被引量:11
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作者 周良辅 杜固宏 《Chinese Medical Journal》 SCIE CAS CSCD 2000年第2期33-36,共4页
Objective To elucidate the diagnosis and surgical treatment of the posterior fossa solid hemangio^blastomas (PFSHs) Methods The data from 22 patients with PFSHs verified by surgery and pathology were analyzed retro... Objective To elucidate the diagnosis and surgical treatment of the posterior fossa solid hemangio^blastomas (PFSHs) Methods The data from 22 patients with PFSHs verified by surgery and pathology were analyzed retrospectively and a review of relevant literature was conducted Results The preoperative definitive diagnosis rate was 13/22 Total tumor removal was achieved in 20 patients Two of the 22 patients died after surgery, one of brain stem injury and the other from an intracranial hemorrhage Twenty patients were followed up for 2 months to 8 yeas (average, 2 years) Karnofsky scale was 80 in 15 patients, 60-70 in 1 patient and not measured in 4 patients who died during follow up The causes of death were pneumonia (2 patients) and purulent meningitis (2) Conclusion MRI and DSA (digital subtraction angiography) are major preoperative diagnostic modalities for PFSH, but PFSH remains a challenging benign neoplasm Special microsurgical techniques and improved operative manipulation can improve surgical efficacy 展开更多
关键词 HEMANGIOBLASTOMA solid tumor posterior fossa MICROSURGERY
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Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients 被引量:5
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作者 Han-Song Sheng Chao-Guo You +4 位作者 Liang Yang Nu Zhang Jian Lin Fen-Chun Lin Mao-De Wang 《Chinese Journal of Traumatology》 CAS CSCD 2017年第4期212-215,共4页
以后的窝硬膜上的 hematomas (PFEDH ) 在孩子是不平常的,但是通常由于威胁生活的 brainstem 压缩的风险要求及时外科的干预。我们试图由与回顾地考察的 trephination mini-craniectomy.MethodsWe 对待选择小儿科的病人使外科的过程... 以后的窝硬膜上的 hematomas (PFEDH ) 在孩子是不平常的,但是通常由于威胁生活的 brainstem 压缩的风险要求及时外科的干预。我们试图由与回顾地考察的 trephination mini-craniectomy.MethodsWe 对待选择小儿科的病人使外科的过程更少侵略从2010年1月为创伤的 PFEDH 在我们的部门被对待到2015年1月 .ResultsDuring 的小儿科的病人的临床的功课,放射学的调查结果,外科的过程,和预测这个时期, 17 个病人的一个总数通过手术为 PFEDH 被对待, 7 为 hemato 与 trephination 微型部分颅骨切除术被管理结果在与格拉斯哥结果 20 评估了的所有 7 个病人好。在这个系列没有死亡。平均 30 月的临床的后续证明没有 complications.ConclusionOur 结果,病人们经历了令人满意的恢复建议 trephination 微型部分颅骨切除术是为有中等 hematoma 的选择 PFEDH 病人的一种安全外科的技术体积和稳定的神经病学的功能。然而,标准部分颅骨切除术是当在神经病学的功能或 hematomas 是的病人有快速的恶化时,推荐大、施加的严重集体效果。 展开更多
关键词 外伤性 患者 血肿 钻孔 儿童 硬膜 外科手术 手术治疗
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Primary Endodermal Sinus Tumor in the Posterior Cranial Fossa:Clinical Analysis of 7 Cases 被引量:1
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作者 Ming-chao Fan Peng Sun +4 位作者 Dong-liang Lin Yi Yu Wei-cheng Yao Yu-gong Feng Li-min Tang 《Chinese Medical Sciences Journal》 CAS CSCD 2013年第4期225-228,共4页
Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fos... Objective To clarify the clinical features,therapeutic method and outcomes of the primary endodermal sinus tumors(ESTs)in the posterior cranial fossa.Methods The English literatures on EST in the posterior cranial fossa were retrieved from PubMed and reviewed.And a 4-year-old boy diagnosed with EST in our hospital was reported.The clinical manifestations,therapy,pathologic features,and prognosis of these cases were analyzed.Results Only seven cases of the ESTs in the posterior cranial fossa were enrolled in this review,including six cases searched from the PubMed and one case from our hospital.Six patients were boy and one patient’s gender was not available from the report.Ages ranged from 1 to 5 years(mean 3.14 years).The mean tumor size in our cohort was 4.4 cm.Six cases came from East Asia.Schiller-Duval bodies were found in all seven neoplasms.All tumors were positive for alpha-fetoprotein.The alpha-fetoprotein level in serum was increased to a very high level before therapy and depressed quickly after the effective chemotherapy.The mean follow-up time was 24.4 months(range 5-52 months).Six tumors were totally removed,and four of them recurred.Three cases died including one whose tumor was partially removed.Conclusions The serum alpha-fetoprotein level is well correlated with the severity of the tumor.A combination of operation and chemotherapy might be the effective management for EST in the posterior cranial fossa.The prognosis of extragonadal intracranial EST is poor. 展开更多
关键词 临床分析 EST序列 PUBMED 蛋白水平 临床特点 英文文献 美国东部
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Trigeminal Ganglioneuroma in the Middle-posterior Cranial Fossa: a Case Report
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作者 TingWang LinMa +1 位作者 Xin Lou BoBu 《Chinese Medical Sciences Journal》 CAS CSCD 2017年第2期123-128,共6页
GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors.It derives from neural crest cells,and can arise from wherever sympathetic tissue exists,1 including neck,posterior mediastin... GANGLIONEUROMA is considered as the most mature and noninvasive form of neuroblastic tumors.It derives from neural crest cells,and can arise from wherever sympathetic tissue exists,1 including neck,posterior mediastinum,adrenal gland,retroperitoneum and pelvis.The two most common locations for this tumor are retroperitoneum and 展开更多
关键词 GANGLIONEUROMA 三叉的神经 计算断层摄影术 磁性的回声成像 中间以后的头部的窝
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The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children
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作者 Duo Chen Xiangtai Wei Qiang Yin Junhong Guan Weiran Pan Chenglin Wang Yunhui Liu 《Chinese Journal of Clinical Oncology》 CSCD 2009年第2期95-99,共5页
OBJECTIVE To analyze and discuss about the clinicalcharacteristics, pathological types, surgical modalities andtechniques, and postoperative complications in children withtumor of posterior cranial fossa .METHODS Retr... OBJECTIVE To analyze and discuss about the clinicalcharacteristics, pathological types, surgical modalities andtechniques, and postoperative complications in children withtumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases ofpediatric tumor of posterior cranial fossa, admitted and treated inour hospital during the period of January 1996 to January 2007.All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases were female. The age ranged from 9months to 14 years old, with an average of 6.1 ± 0.5 of age. CranialCT or MRI examination was conducted before and after thesurgery on all patients.RESULTS The primary manifestations for this group of patientswere increased intracranial pressure and/or ataxia. Postoperativepathological diagnoses showed: 46 cases of medulloblastoma, 43cases of astrocytoma, 11 cases of ependymoma (including 1 caseof degenerative ependymoma), 1 case of dermoid cyst, and 1 caseof teratoma. In this group of the patients, radical surgery wasused in 68 cases and subtotal surgical removal used in 31 cases,while surgical removal of large section was performed on 3 cases.There were no deaths from surgery reported. Ninety-one casesshowed significant symptomatic improvement when comparedwith preoperative conditions, while 11 cases showed either noimprovement or more severely affected afterward. For 6 cases,postoperative ventriculoperitoneal shunt was performed within7 days to 2 months after the surgery. Sixty-three patients gainedfollow-up for 3 to 60 months in duration. Thirty-nine patientsregained normal life and were able to learn well, while there were7 patients who could not live normally on their own. During thefollow-up period, there were 17 cases of recurrence and 7 casesof death. In 23 cases of medulloblastoma in children with age of3 years old or above, 2 cases who underwent surgical removal ofintracranial ependymoma received small dosage of postoperativeX-ray radiotherapy on the the brain and spinal cord. Nine casesof medulloblastoma in children under age of 3 and 17 cases ofastrocytoma diagnosed after the surgery received chemotherapyof Carmustine.CONCLUSION Medulloblastomas and astrocytomas werethe most common types of pediatric tumor of posterior cranialfossa, right followed by ependymoma, and dermoid cysts andteratomas were rare. Early correct diagnosis, proper selection ofappropriate surgical modality and the surgical margin, propertreatment of postoperative complications, and the selecting rightradiotherapy or chemotherapy were the key factors in influencingthe prognostic outcome of children with tumor of posterior cranialfossa. 展开更多
关键词 显微外科治疗 儿童肿瘤 后颅窝 儿童髓母细胞瘤 颅内室管膜瘤 病理诊断结果 星形细胞瘤 脑室腹腔分流术
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Adult Posterior Cranial Fossa Arachnoid Cyst: A Case Report
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作者 Ibrahima Berete Alpha Boubacar Bah +3 位作者 Hammas Nawal Mohammed Benzagmout Khalid Chakour Faiz Chaoui 《Open Journal of Modern Neurosurgery》 2019年第4期436-440,共5页
Adult posterior fossa arachnoid cysts are rare lesions that are considered to be mostly congenital in origin. We present 49-year-old man admitted with a chief complaint of tremor and balance problems for the past 2 mo... Adult posterior fossa arachnoid cysts are rare lesions that are considered to be mostly congenital in origin. We present 49-year-old man admitted with a chief complaint of tremor and balance problems for the past 2 months. He had ataxia on examination. Magnetic resonance imaging revealed a well circumscribed midline cystic lesion of the posterior fossa sharing the same signal characteristics as cerebrospinal fluid and non-communicating to the fourth ventricle. He underwent surgical treatment for his symptomatic posterior fossa arachnoid cyst with a good outcome at 2 years follow up. 展开更多
关键词 posterior fossa ARACHNOID CYST Subocciptal CRANIOTOMY CEREBELLAR ATAXIA
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Discussion of overlaped CT image in cerebral function of fossa cranii posterior
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作者 徐元昌 王开祥 +1 位作者 蔡炬 郭爱华 《中国临床康复》 CSCD 2003年第6期1044-1045,共2页
AIM:To discuss the value of technique of overlapped CT image in cerebral function of fossa cranii posterior.METHODS:27 cases of diseases of fossa cranii posterior were examined by three techenics(10 mm scan, 6 mm scan... AIM:To discuss the value of technique of overlapped CT image in cerebral function of fossa cranii posterior.METHODS:27 cases of diseases of fossa cranii posterior were examined by three techenics(10 mm scan, 6 mm scan, 3mm scan and overlapped image),and then compare the quality of image, accuracy rate of diagnoses, misdiagnosis rate between the three techniques.RESULTS:The quality of image of ovelaped image was better than the other.The accuracy rate of diagnosis were 77.8%, 85.2%and 96.3%.The false positive rate were 14.8%,11.1%and 3.7%.The false negtive rates were 7.4%,3.7%and 0.CONCLUSION:There was important value for diagnosis of diseases of fossa cranii posterior with technique of overlapped CT image,and can provide help for estimation of the cerebral function. 展开更多
关键词 CT图像重叠技术 启颅凹 脑功能 诊断
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颅后窝畸胎瘤的影像及临床特点分析
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作者 李锐 张茂柏 +3 位作者 李志兵 梁廷宇 霍恺 郝解贺 《中国微侵袭神经外科杂志》 CAS 2024年第1期8-10,共3页
目的探讨分析后颅窝畸胎瘤的影像与临床特点。方法回顾性分析5例颅后窝畸胎瘤病人的CT、MRI资料及临床资料。病变位于小脑蚓部4例,右桥脑小脑角1例。采用枕下后正中入路4例,乙状窦后入路1例。结果肿瘤全切除3例,近全切除2例。术后病理... 目的探讨分析后颅窝畸胎瘤的影像与临床特点。方法回顾性分析5例颅后窝畸胎瘤病人的CT、MRI资料及临床资料。病变位于小脑蚓部4例,右桥脑小脑角1例。采用枕下后正中入路4例,乙状窦后入路1例。结果肿瘤全切除3例,近全切除2例。术后病理均提示:成熟囊性畸胎瘤。术后症状大多缓解,术后发生无菌性脑炎1例,癫痫伴精神异常1例,共济失调加重1例。5例病人均获随访,时间3个月~5年,1例复发。结论颅后窝畸胎瘤非常罕见,多发生于中线部位,典型者有特异的影像表现,非典型者诊断主要依据病理结果。显微手术切除是主要治疗方式。 展开更多
关键词 畸胎瘤 颅后窝 影像学特点 磁共振成像 显微外科手术
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3D-ASL的rCBF max值在儿童后颅窝肿瘤鉴别诊断中的价值
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作者 盛思思 邵剑波 +2 位作者 彭雪华 郭豫 朱百奇 《放射学实践》 CSCD 北大核心 2024年第4期523-527,共5页
目的:探讨三维动脉自旋标记成像(3D-ASL)参数rCBF_(max)对儿童后颅窝肿瘤的诊断价值。方法:回顾性分析2018年1月-2022年12月在本院经手术病理证实的52例后颅窝肿瘤患儿的临床和术前MRI资料(平扫、增强和3D-ASL)。其中,髓母细胞瘤28例,... 目的:探讨三维动脉自旋标记成像(3D-ASL)参数rCBF_(max)对儿童后颅窝肿瘤的诊断价值。方法:回顾性分析2018年1月-2022年12月在本院经手术病理证实的52例后颅窝肿瘤患儿的临床和术前MRI资料(平扫、增强和3D-ASL)。其中,髓母细胞瘤28例,毛细胞星形细胞瘤11例,室管膜瘤13例。测量肿瘤实性区域的最大脑血流量(CBF_(max))值,并计算最大相对脑血流量(rCBF_(max)=CBF_(max)/CBF_(健侧正常脑灰质))。采用Kruskal-Wallis检验比较3组肿瘤的rCBF_(max)值,采用ROC曲线和约登指数来确定rCBF_(max)鉴别肿瘤病理类型的最佳阈值、敏感度、特异度和曲线下面积(AUC)。结果:室管膜瘤的rCBF_(max)值最高,为1.53(1.27,2.04),毛细胞星形细胞瘤的rCBF_(max)值最低,为0.69(0.56,0.76),髓母细胞瘤的rCBF_(max)值为0.90(0.84,1.00)。三组肿瘤的rCBF_(max)值比较,差异有统计学意义(P<0.001)。ROC曲线分析显示鉴别室管膜瘤与髓母细胞瘤的rCBF_(max)最佳阈值为1.13,相应的诊断敏感度为100%,特异度为82.1%,AUC为90.7%;鉴别髓母细胞瘤与毛细胞星形细胞瘤的rCBF_(max)最佳阈值为0.80,相应的诊断敏感度为85.7%,特异度为100%,AUC为97.1%。结论:3D-ASL定量参数rCBF_(max)对常见儿童后颅窝肿瘤的鉴别诊断具有较高的临床应用价值。 展开更多
关键词 后颅窝肿瘤 儿童 动脉自旋标记成像 脑血流量 磁共振成像
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基于德尔菲法构建后颅窝肿瘤患儿家长健康教育护理路径
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作者 何久智 王瑞 张凤云 《中国健康教育》 北大核心 2024年第2期172-176,共5页
目的 构建导向明确、简洁易行的后颅窝肿瘤患儿家长健康教育护理路径。方法 通过查阅文献,访谈医务人员并结合临床患儿家长健康教育需求,初步构建健康教育护理路径表。进行两轮德尔菲专家咨询,将专家意见整理、修改后形成后颅窝肿瘤患... 目的 构建导向明确、简洁易行的后颅窝肿瘤患儿家长健康教育护理路径。方法 通过查阅文献,访谈医务人员并结合临床患儿家长健康教育需求,初步构建健康教育护理路径表。进行两轮德尔菲专家咨询,将专家意见整理、修改后形成后颅窝肿瘤患儿家长健康教育护理路径。结果 两轮专家咨询问卷的有效回收率均为100%,专家权威系数为0.84。首轮函询所有指标的重要性赋值均数范围为(4.18~5.00)分,满分比范围为47.06%~100%。第二轮函询指标重要性赋值均数范围为(3.75~4.88)分,满分比范围为41.12%~88.24%。两轮函询专家意见协调系数分别为0.152和0.155,显著性检验P<0.05。通过两轮专家咨询和指标的筛选,构建了包含8个一级指标、46个二级指标的后颅窝肿瘤患儿家长健康教育护理路径表。结论 本研究构建的后颅窝肿瘤患儿家长健康教育护理路径表具有科学性,简便可行,可为临床护士的健康教育工作提供指导工具。 展开更多
关键词 后颅窝肿瘤 健康教育路径 德尔菲法
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经颅脑血管多普勒超声在小儿Ⅰ型Chiari畸形诊断及疗效评估中的应用研究
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作者 王君璐 张立 +2 位作者 刘剑钢 刘瑜 肖波 《临床小儿外科杂志》 CAS CSCD 北大核心 2024年第2期140-146,共7页
目的研究经颅脑血管多普勒(transcraniocerebral vessel Doppler,TVD)超声技术在I型Chiari畸形患儿诊断以及术后疗效评估中的应用价值。方法回顾性分析2018年3月至2021年12月上海交通大学医学院附属儿童医院神经外科收治的27例Ⅰ型Chiar... 目的研究经颅脑血管多普勒(transcraniocerebral vessel Doppler,TVD)超声技术在I型Chiari畸形患儿诊断以及术后疗效评估中的应用价值。方法回顾性分析2018年3月至2021年12月上海交通大学医学院附属儿童医院神经外科收治的27例Ⅰ型Chiari畸形患儿临床资料。按年龄分为两组,学龄前组(1~6岁)15例,学龄后组(7~16岁)12例。两组患儿均于术前、术后24 h及术后1个月行TVD超声探测,以后颅窝内双侧大脑后动脉(posterior cerebral artery,PCA)、椎动脉(vertebral artery,VA)及基底动脉(basilar artery,BA)为靶血管,收集相应靶血管的收缩期峰流速(peak systolic velocity,PSV)、舒张末期流速(end-diastolic velocity,EVD)及搏动指数(pulsative index,PI)等监测指标。分别比较两组患儿手术前后后颅窝动脉血流动力学差异;比较27例患儿术前TVD与MRI诊断结果的一致性,以及术后TVD检查结果与Tator疗效评估结果的一致性。结果学龄前组患儿手术后双侧PCA的PSV较术前增加[左侧:(44.25±13.06)cm/s比(66.76±14.45)cm/s,t=5.148,P=0.023;右侧:(45.12±13.41)cm/s比(65.33±10.12)cm/s,t=5.389,P=0.021]、PI较术前降低[左侧:(1.18±0.42)比(0.91±0.18),t=4.545,P=0.033;右侧:(1.24±0.48)比(0.92±0.13),t=4.776,P=0.028];双侧VA的PSV[左侧:(43.50±11.99)cm/s比(70.94±7.56)cm/s,t=7.042,P=0.008;右侧:(44.56±8.45)cm/s比(68.82±9.02)cm/s,t=6.833,P=0.009]、EVD[左侧:(19.01±9.22)cm/s比(27.18±8.53)cm/s,t=4.587,P=0.032;右侧:(18.28±5.77)cm/s比(28.32±7.26)cm/s,t=4.683,P=0.030]较术前增加,双侧PI较术前降低[左侧:(1.12±0.45)比(0.86±0.19),t=4.712,P=0.029;右侧:(1.31±0.46)比(0.84±0.31)cm/s,t=5.277,P=0.022];BA的PSV[(48.75±16.57)cm/s比(69.17±11.86)cm/s,t=5.413,P=0.019]、EVD[(27.73±7.34)cm/s比(27.18±8.53)cm/s,t=4.738,P=0.027]较术前增加、PI较术前降低[(1.13±0.55)比(0.90±0.28),t=4.721,P=0.030]。学龄后组患儿手术后双侧VA的PSV较术前增加[左侧:(48.16±18.47)cm/s比(53.77±24.73)cm/s,t=4.187,P=0.045;右侧:(45.72±18.53)cm/s比(56.31±19.82)cm/s,t=3.872,P=0.036],BA的PSV[(48.50±11.44)cm/s比(58.17±18.86)cm/s,t=5.108,P=0.024]、EVD[(18.63±9.91)cm/s比(23.19±10.63)cm/s,t=4.763,P=0.029]较术前增加、PI较术前降低[(1.06±0.42)比(0.92±0.25),t=4.572,P=0.032]。27例术前TVD超声检出率低于MRI(χ^(2)=5.511,P=0.019);术后1个月Tator疗效评估症状改善19例(19/27,70.4%)、无改善8例(8/27,29.6%);TVD超声监测指标改善22例(22/27,81.5%)、无改善5例(5/27,18.5%),TVD超声检查与Tator疗效评估结果具有较高的一致性(χ^(2)=0.911,P=0.340)。结论小儿Ⅰ型Chiari畸形的诊断应以MRI检查结果为金标准,但本研究中TVD超声具有一定的准确性和辅助性,可有效显示Ⅰ型Chiari畸形患儿后颅窝动脉的血流动力学变化,间接、无创地评估颅内压,不仅可以帮助医师及时诊断、给予治疗,同时TVD超声对于Ⅰ型Chiari畸形术后疗效评估也有良好的应用价值。 展开更多
关键词 CHIARI畸形 超声检查 多普勒 经颅 颅窝 脑血管循环 外科手术 治疗结果 儿童
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后颅窝术后病人获得性吞咽障碍危险因素分析 被引量:2
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作者 戚春霞 张雅芝 +4 位作者 厉春林 杨琴 李月婷 高亭 杜晓亮 《护理研究》 北大核心 2023年第7期1158-1163,共6页
目的:调查后颅窝术后获得性吞咽障碍的发生现状及危险因素,为早期干预吞咽障碍和优化术后康复方案提供参考。方法:选择2021年1月—9月在我院住院的后颅窝手术治疗病人290例为研究对象,收集病人一般资料及吞咽障碍相关指标,对拔除气管插... 目的:调查后颅窝术后获得性吞咽障碍的发生现状及危险因素,为早期干预吞咽障碍和优化术后康复方案提供参考。方法:选择2021年1月—9月在我院住院的后颅窝手术治疗病人290例为研究对象,收集病人一般资料及吞咽障碍相关指标,对拔除气管插管后4 h的病人使用标准吞咽功能评估量表进行吞咽功能评估。采用Logistic回归分析筛选主要危险因素,并绘制受试者工作特征曲线(ROC)和吞咽功能恢复时间曲线。结果:290例后颅窝术后病人中113例(38.97%)发生吞咽障碍,吞咽功能恢复时间为(9.49±10.06)d。Logistic回归结果显示,病变部位大小及面瘫分级是后颅窝术后病人获得性吞咽障碍的危险因素。结论:后颅窝术后病人获得性吞咽障碍的发生率较高,病变范围和面瘫分级可联合诊断后颅窝术后病人获得性吞咽障碍的发生。护理人员应重视后颅窝病变术后病人的吞咽功能,早期实施护理干预。 展开更多
关键词 后颅窝病变 吞咽障碍 危险因素 恢复时间 护理
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