脑室及脑实质内神经鞘瘤临床特点分析  

Clinical features of intracranial intraparenchymal and intraventricular schwannomas

作　　者：蒋念[1] 潘舟洋 陈银华 廖宇翔 廖新斌[1] 张治平[1] JIANG Nian;PAN Zhouyang;CHEN Yinhua;LIAO Yuxiang;LIAO Xinbin;ZHANG Zhiping(Department of Neurosurgery,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《国际神经病学神经外科学杂志》2024年第3期45-54,共10页Journal of International Neurology and Neurosurgery

基　　金：湖南省自然科学基金资助项目(2022JJ40793)。

摘　　要：目的总结脑室及脑实质内神经鞘瘤的临床特点。方法收集2010年6月—2020年6月中南大学湘雅医院诊治的13例脑室及脑实质内神经鞘瘤病例,并分析患者的一般资料、症状、体征、影像学资料、手术记录以及住院治疗经过。结果13例非颅神经起源的脑实质内或脑室神经鞘瘤,占同期神经鞘瘤的0.45%。患者年龄1~71岁,平均35.7岁;男性9例,女性4例(男∶女=2.25∶1.00)。患者症状出现时间从4 d到3年不等,最常见的首发症状是头痛,其次是癫痫发作。肿瘤位于额叶最常见,其次为小脑半球和颞叶。囊变、瘤周水肿是该肿瘤常见影像学特征,1例病例出现钙化。该13例术前均误诊为其他类型肿瘤,多数诊断为胶质瘤或脑膜瘤。结论脑室及脑实质内神经鞘瘤是一种罕见的肿瘤,术前难以与实质性肿瘤鉴别。该肿瘤起因不明,手术为首选治疗方式,除恶性神经鞘瘤外预后均较好。Objective To summarize the clinical features of intracranial intraparenchymal and intraventricular schwannomas.Methods A total of 13 patients with intracranial intraparenchymal and intraventricular schwannomas who were diagnosed and treated in Xiangya Hospital of Central South University from June 2010 to June 2020,and related data were analyzed,including general information,symptoms,signs,radiological features,surgical procedures,and treatment process.Results The 13 cases of intraparenchymal or intraventricular schwannomas did not originate from the cranial nerve,accounting for 0.45%of all cases of schwannomas during the same time period of time.The age of the patients ranged from 1 to 71 years,with a mean age of 35.7 years,and there were 9 male patients and 4 female patients,with a male/female ratio of 2.25:1.00.The time to disease onset ranged from 4 days to 3 years,and headache was the most common initial symptom,followed by seizures.Most tumors were located in the frontal lobe,followed by the cerebellar hemispheres and the temporal lobe.intralesional cysts and peritumoral edema were common radiological features,and calcification was observed in one case.All 13 cases were misdiagnosed as other tumors before surgery,and most of them were diagnosed as glioma or meningioma.Conclusion Intracranial intraparenchymal and intraventricular schwannomas are rare neoplasms,and it is difficult to differentiate them from other solid tumors before surgery.The histogenesis of this tumor remains unknown,and surgery is the preferred treatment option.A favorable prognosis is observed for all types except malignant schwannoma.

关 键 词：神经鞘瘤 脑实质 脑室 临床特点 神经影像 组织病理 

分 类 号：R739.41[医药卫生—肿瘤]