高原地区脑肿瘤急性脑疝11例分析  

Acute Cerebral Herniation in Plateau Area due to Intracranial Tumors:Analysis of 11 Cases

作　　者：蒲智[1] 阿旺益西[1] 

机构地区：[1]西藏自治区人民医院神经外科,西藏拉萨850000

出　　处：《中国神经肿瘤杂志》2006年第3期219-221,共3页Chinese Journal of Neuro-Oncology

摘　　要：背景和目的:脑肿瘤患者在高原地区的临床表现有其特点。本文对西藏高原脑肿瘤发生急性脑疝的临床表现、诱发因素、辅助检查、治疗和结果进行分析讨论。方法:回顾性分析1999年1月至2005年12月,经手术治疗的11例急性脑疝的脑肿瘤病例。其中男性3例,女性8例,年龄31～52岁,平均38.9岁。汉族10例,8例为急进高原,2例暂住3个月;藏族1例,从海拔4500米到3700米后发病。结果:所有患者均接受了颅脑CT检查,肿瘤直径3～6㎝,其中3例接受了MRI检查。8例急诊行开颅肿瘤切除术,3例经抗癫痫、脱水、对症治疗后择期手术,无手术死亡。肿瘤病理诊断均为脑膜瘤。结论:头痛、呕吐、癫痫发作、昏迷是高原地区急性脑疝最常见的临床症状,从平原地区急进高原是最常见的诱因。颅脑CT是最快速准确的诊断方法。经抗癫痫、脱水等治疗意识好转不明显者,应尽早手术。BACKGROUND ＆ OBJECTIVE： Acute cerebral herniation in plateau area due to brain tumor could have distinctive clinical manifestation. In this article, the clinical characteristic, causative factors, laboratory examinations, treatments and prognosis of acute brain herniation due to intracranial tumors in plateau area were analysed. METHODS： Eleven patients with acute brain herniation due to intracranial tumors who received operation in our department from 1999 to 2005 were reviewed. In this group, 10 cases were plain residents, among which 8 cases experienced sudden coming into plateau area and 2 cases had temporally lived in the plateau area for 3 months. Another case was local resident, who developed acute brain herniation when descending from 4500 to 3700 metres altitude.The age of the patients ranged from 31 to 52 years old （average 38.9 years old）. RESULT： All the patients received CT scan examination and 3 cases did MRI scan. The tumors＂ diameter ranged from 3 to 6 cm. The craniotomy was done urgendy in 8 cases to remove the tumor. There were 3 cases whom firstly received adequate medical therapy including anti-convulsants, dehydration and symptomatic treatments, then surgery was done in scheduled time. There were no surgical mortality. All the removed tumors were pathologically diagnosed meningiomas. CONCLUSIONS： Headaches, vomiting, epilepsy and coma are the most frequent clinical symptoms in the patients with acute brain hernia due to brain tumors in plateau area, and sudden coming into plateau is the primary causative factor. If there was no improvement for consciousness level after proper medical therapy, craniotomy should be performed immediately.

关 键 词：高原 脑肿瘤 急性脑疝 诊断 治疗 

分 类 号：R739.41[医药卫生—肿瘤]