脑室内中枢神经细胞瘤诊治分析  

Clinical effect of microsurgery on intraventricular central neurocytomas (report of 9 cases)

作　　者：熊忠伟[1] 孙守家[1] 章剑剑[1] 韩庆东[1] 王煜[1] 雷霆[1] 陈劲草[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030

出　　处：《中国临床神经外科杂志》2014年第1期1-3,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家临床重点专科项目资助

摘　　要：目的探讨脑室内中枢神经细胞瘤（ICN）的诊断及手术治疗效果。方法回顾性分析我科手术治疗并经病理学确诊的9例ICN患者的临床资料。结果肿瘤全切除6例，次全切除3例。无手术死亡病例。1例术前放疗肿瘤体积明显缩小，4例术后辅助放疗。所有患者术后随访3～44月，平均18．7月；2例复发，行γ刀切除；2例并发脑积水行脑室一腹腔分流术；其余患者恢复良好，无肿瘤复发或进展。结论ICN多以慢性颅内高压症状起病，缺乏局灶性神经系统缺损症状，但大多ICN术前根据特征性影像学表现可获得诊断。手术应作为治疗的首选方法，并力争在安全前提下全切除，可获得良好预后。Objective To investigate the clinical characteristics, diagnosis and treatment of intraventricular central neurocytomas （ICNs）. Methods The clinical data of 9 patients with ICNs who underwent microsurgery were analyzed retrospectively. All the patients were followed up for 18.7 months （range, 3-44 months）. Results All the patients suffered from chronically elevated intracranial pressure. No patient presented with focal neurological deficits. Of 9 patients, 6 underwent microsurgery through transcortical approach and 3 through transcallosal approach. Total resection of ICNs was achieved in 6 patients and subtotal in 3. Four patients, of whom, 1 total resection and 3 subtotal, received radiotherapy after the operation. No patient received chemotherapy after the operation. The postoperative mutism occurred in 2 patients who were treated by microsurgery through transcallosal approach. Two patients, who received subtotal resection, recurred during the follow-up period and received gamma knife radiotherapy. Two patients received ventriculoperitoneal shunt due to hydrocephalus. The other patients recovered well without recurrence or progression during the follow-up period. Conclusions Most patients with ICNs present with the symptoms of chronic increased intracranial pressure and lack focal neurological deficits. Microsurgery is an effective treatment for ICNs and good prognoses may be obtained by total resection of the tumors in the patiets with ICNs.

关 键 词：脑室内中枢神经细胞瘤 诊断 治疗 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]