幕上巨大脑膜瘤合并烟雾病的手术切除及文献复习  

Surgical resection of giant supratentorial meningioma associated with Moyamoya disease:a case report and literature review

作　　者：陈超 韩国胜 戴冬伟 洪波 刘建民 王来兴 

机构地区：[1]海军军医大学长海医院神经外科,上海200438

出　　处：《中国微侵袭神经外科杂志》2017年第8期340-342,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金青年项目(编号:81402076)

摘　　要：目的总结合并烟雾病的幕上巨大脑膜瘤的诊治经验。方法回顾性分析1例合并烟雾病的幕上巨大脑膜瘤病人的临床资料。术前DSA检查明确颅内外血管代偿和肿瘤血供来源,行左侧大脑半球巨大脑膜瘤切除术。结果术中全切肿瘤,病理结果为WHOⅠ级脑膜瘤。病人术后出现意识障碍,提示下丘脑功能紊乱导致激素水平低下,给予激素补充治疗,情况改善后出院。结论脑膜瘤合并烟雾病病人的手术耐受性差,易出现缺血性、出血性并发症。术前脑血管DSA明确诊断、合适的手术策略及精细的手术操作可减少手术创伤,预防并发症的发生。Objective To summarize the diagnosis and treatment experience of giant supratentorial meningioma associated with Moyamoya disease. Methods Clinical data of 1 patient with giant supratentorial meningioma associated with Moyamoya disease were analyzed retrospectively. The intracranial and extracranial compensatory vessels and blood supplies of tumors were confirmed by preoperative DSA examination. The patient received the resection of the tumor in the left cerebral hemisphere. Results The tumor was removed totally. The pathological diagnosis was meningioma in WHOⅠgrade. The disturbance of consciousness occurred after surgery,indicating the disturbance of hypothalamus function and low hormone level. The patient received hormone supplement therapy and discharged with status improvement. Conclusions Giant supratentorial meningioma associated with Moyamoya disease has a poor operational tolerance and makes patient easy to suffer the ischemic and hemorrhagic complications. Preoperative DSA diagnosis, proper surgery strategy and careful surgical operation can reduce the operative injury and prevent the complications.

关 键 词：脑膜瘤 巨大 脑底异常血管网病 幕上 神经外科手术 

分 类 号：R739.45[医药卫生—肿瘤] R743[医药卫生—临床医学]