副神经血管减压治疗痉挛性斜颈(附2例报告及文献复习)  

Accessory nerve vascular decompression for treatment of spasmodic torticollis

作　　者：孙克华[1] 卢亦成[1] 骆纯[1] 侯立军[1] 周健[1] 

机构地区：[1]第二军医大学长征医院神经外科,200003

出　　处：《临床神经外科杂志》2007年第4期167-169,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨痉挛性斜颈的发病原因,评价副神经血管减压治疗痉挛性斜颈的效果。方法对2例痉挛性斜颈经过其他方法治疗无效且不愿意选择肌肉和神经切断的患者行副神经血管减压。术中发现椎动脉严重压迫副神经,用柔软的涤纶绵将神经与血管隔开而达到充分减压。结果例1在术后早期症状有所改善,术后3个月完全恢复正常。例2手术后3周头、颈位置已恢复正常,术后3个月症状进一步改善。结论血管压迫副神经是引起痉挛性斜颈的病因之一,副神经血管减压对某些痉挛性斜颈确有疗效,但应该严格筛选和控制手术适应证,术后应建立客观评价疗效的标准。Objective To study the real mechanism of spasmodic torticollis, and to investigate the effective approach for treatment of spasmodic torticollis. Methods We selected neurovascular decompression for treatment of 2 patients with spasmodic torticollis, who were diagnosed previously by clinic, neuroradiology and MEG,and failed to medication therapy. In our department, 2 spasmodic torticollic patients were underwent microvascular decompression. During operation, all patients were noted that cranial nerves of eleventh, tenth and ninth had tightly compression by the vertebral artery and posterior inferior cerebellar artery. The nerves and arteries were dissected carefully and seperated by Teflon sheets in operation. Results The symptoms and signs were gradual improved postoperatively. The positions and the movements of head and neck in case 1 turned normal in 3 months after operation . In case 2,her positions and movements of neck and head were normally in 2 to 3 weeks after microneurovascular decompression. Conclusions The mieroneurovascular decompression is an effective approach for some spasmodic tortieollic patients. However, we must pay more attention to this treatment method. The mechanism of spasmodic torticollis is still unclear up to now.

关 键 词：痉挛性斜颈 神经血管减压 

分 类 号：R746[医药卫生—神经病学与精神病学]