小脑脑桥角海绵状血管畸形三例并文献复习

目的 总结小脑脑桥角(CPA)区海绵状血管畸形(CMs)的临床表现、影像学特征及治疗特点.方法 2005年6月至2010年6月我科共收治CPA区CMs病例3例,进行报告.搜索MEDLINE上自1985年至2010年文献查到此类病例5例,进行文献复习.结果 文献复习的5例CMs临床表现为脑神经及小脑受累症状,但无脑干受压症状;影像见CMs均呈囊实性,与内听道及颅底硬膜无粘连;术中见CMs与周边结构有粘连,但可进行分离;手术治疗效果满意.本文报告的3例临床特征与之相符.结论 当CPA区见囊性病变与内听道及颅底硬膜无粘连时,应考虑到CMs的可能,显微外科手术切除多能获得良好的疗效.

Abstract：

Objective To investigate the clinical presentation, imaging features and treatment experience of cystic cavernous malformations ( CMs ) in the cerebellopontine angle ( CPA ) . Methods Three patients with the CMs of the CPA between 2005 and 2010 in our institute were summarised. Five patients from MEDLINE search of the English literature from 1985 to 2010 for CMs of the CPA were identified. We reviewed the characteristics of these 5 cases and our cases. Results Their presenting symptoms of 5 cases in the literature included headache, injury of cranial nerves in the CPA and cerebellar symptoms. But they did not show signs of brain stem compression. MRI and /or CT scans showed that the lesions in the eight cases of CMs all had solid and cystic components, and no adhesion with internal auditory canal and skull base dura mater was present in the CPA. Despite the fact that cystic CMs also involved cranial nerves, cerebellum, brainstem and arteries, they could be separated from these surrounding structures thanked to the presence of well - margined adhesion, which was contrary to solid CMs. We reported three cystic CMs of the CPA in our institute that was the same as the above. Conclusion Although cystic CMs of the CPA had no established imaging features, a diagnosis of CMs may be suspected when a cystic lesion is present in the CPA and does not involve internal acoustic meatus or dura matter of the skull base. Skillful microsurgical techniques will secure good outcomes for patients with cystic CMs in the CPA.

Cystic cavernous malformations in the cerebellopontine angle:report of three cases and literature review

Objective To investigate the clinical presentation, imaging features and treatment experience of cystic cavernous malformations ( CMs ) in the cerebellopontine angle ( CPA ) . Methods Three patients with the CMs of the CPA between 2005 and 2010 in our institute were summarised. Five patients from MEDLINE search of the English literature from 1985 to 2010 for CMs of the CPA were identified. We reviewed the characteristics of these 5 cases and our cases. Results Their presenting symptoms of 5 cases in the literature included headache, injury of cranial nerves in the CPA and cerebellar symptoms. But they did not show signs of brain stem compression. MRI and /or CT scans showed that the lesions in the eight cases of CMs all had solid and cystic components, and no adhesion with internal auditory canal and skull base dura mater was present in the CPA. Despite the fact that cystic CMs also involved cranial nerves, cerebellum, brainstem and arteries, they could be separated from these surrounding structures thanked to the presence of well - margined adhesion, which was contrary to solid CMs. We reported three cystic CMs of the CPA in our institute that was the same as the above. Conclusion Although cystic CMs of the CPA had no established imaging features, a diagnosis of CMs may be suspected when a cystic lesion is present in the CPA and does not involve internal acoustic meatus or dura matter of the skull base. Skillful microsurgical techniques will secure good outcomes for patients with cystic CMs in the CPA.