脑干血管畸形的外科治疗  

Surgical treatment of brain stem vascular malformation

作　　者：姚鑫[1] 孙梅[1] 杨玉山[1] 焦德让[1] 秦进喜[2] 李庆彬[1] 只达石[1] 

机构地区：[1]天津市环湖医院神经外科,300060 [2]天津市环湖医院病理科,300060

出　　处：《现代神经疾病杂志》2001年第1期34-36,共3页

摘　　要：目的 探讨脑干血管畸形的外科治疗方法、手术入路和治疗效果。方法 对10例脑干血管畸形患者进行回顾性分析,男8例,女2例;平均年龄34.4岁。所有患者均经CT和MRI检查确诊为脑干血管畸形。有6例患者行DSA检查,但无异常发现。病变位于桥脑者6例,桥脑中脑结合部者3例,桥脑延髓结合部者1例。结果 10例患者平均在出血后第34 d行开颅手术,其中经后颅窝中线小脑下蚓部第四脑室入路5例,于枕下乙状窦后经小脑外侧入路4例,经颞下切开天幕入路1例。术后病理学检查报告:毛细血管扩张症6例、海绵状血管瘤3例、动静脉畸形1例,无手术死亡病例。所有患者术后症状均获改善,有6例患者获得随访,最长随访时间6年。最短1年,无再出血。结论 应用显微外科手术治疗脑干血管畸形患者安全有效,通过切除畸形的脑干血管可防止再次出血。Objective The surgical treatment, approaches and result in ten patients with brain stem vascular malformation(BVM) was reported. Methods Ten cases of BVM (8 male and 2 female, average age 34.4 years)were diagnosed by CT and MRI showing the lesions in pons 6 cases, in pontomesencephalic junction 3 cases and in pontomedullary junction 1 case. Results The mean interval from the occurrence of hemorrhage to operation was 34 days. Surgical approaches were accessing via suboccipital midline transfourth ventrical 5 cases, suboccipital retrosigmoid 4 cases and subtemporal transtentorial 1 case. The pathological examination demonstrated that there were capillary telangiectasia 6 cases, cavernous angiomas 3 cases and AVM 1 case. All the patients had good outcome. Conclusion Microsurgical resection of BVM is safe and effective which can extirpate the lesion and prevent from rebleeding.

关 键 词：脑动静脉畸形 脑干 神经外科手术 显微外科手术 

分 类 号：R651.2[医药卫生—外科学]