后颅窝病变疑难病例6例报告  

Six Intractable Cases of Posterior Cranial Fossa Affection

作　　者：赵世光[1] 杨孔宾[1] 张豫滨[1] 甄云波[1] 叶远柱[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院神经外科,黑龙江哈尔滨150000

出　　处：《中国神经肿瘤杂志》2006年第2期89-92,共4页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:后颅窝占位病变的术前诊断有时并不容易。本文报告我们日常临床工作中遇到的后颅窝病变中诊断困难的病例并分析其特点。方法:统计哈尔滨医科大学第一临床学院神经外科2004年4月至2006年4月的后颅窝病变手术病例,选择6例诊断困难的病例,分析总结发病方式、临床症状和体征、辅助检查、手术所见和组织学检查。结果:6例病例中,其中3例术前诊断为前庭神经鞘瘤,术后证实为脑膜瘤。1例术前诊断为脑梗塞,术后证实为畸胎瘤。1例术前诊断为脑膜瘤,术后证实为畸胎瘤。1例术前诊断为脑膜瘤,术后证实为黑色素瘤。结论:(1)桥小脑角区脑膜瘤和前庭神经鞘瘤容易混淆。(2)先天性良性肿瘤畸胎瘤容易误诊为其他脑肿瘤或脑梗塞。(3)一些罕见的肿瘤容易误诊,如黑色素瘤。BACKGROUND ＆ OBJECTIVES： It is sometimes very difficult to diagnose accurately for certain affections of posterior cranial fossa. And thus it is useful for clinical personnel to share findings on the characteristics of such affections. METHOD： We reviewed 6 intractable cases of posterior cranial fossa lesions treated at our institution between April 2004 and April 2006. The clinical presentation, symptoms, investigation, operative finding and histopathology were detailed. RESULTS： Among the 6 cases, 3 were meningeomas that have been misdiagnosed as vestibular nerve neuroma before surgery; one teratoma, was misdiagnosed as cerebral infarction. The fifth case was also a teratoma, misdiagnosed as meningeoma before operation, and the last one was a melanoma, misdiagnosed as meningeoma. CONCLUSION： There are some difficulties in making an accurate diagnosis of acoustic neuromas or meningeomas in the CPA region. Some benign teratomas may easily be misdiagnosed as cerebral infarction or other brain tumors. It is even easier to confuse the diagnosis of some uncommon tumors, for example melanoma, with other brain tumors.

关 键 词：误诊 后颅窝 脑肿瘤 

分 类 号：R739.41[医药卫生—肿瘤]