中脑顶盖部胶质瘤的外科治疗

目的探讨中脑顶盖部胶质瘤的外科手术治疗方法及结果。方法回顾性分析9例中脑顶盖部胶质瘤病人的临床资料。均采用显微外科手术切除,其中枕部经小脑幕入路8例,经幕下小脑上入路1例。结果肿瘤均全切除,病理均为低级别胶质瘤,术后并发双眼上视困难1例,无其他手术并发症,无死亡病例。脑积水完全缓解8例,1例仍有头痛、呕吐症状,再次行内镜下第三脑室底造瘘术。所有病人随访1～5年,MRI未见肿瘤复发,眼球运动障碍有不同程度恢复,KPS评分90～100分。结论中脑顶盖部胶质瘤临床罕见,病理级别相对良性,进行积极的显微外科治疗能取得较好的效果。

Surgical treatment of tectal plate gliomas

Objective To discuss the method and outcome for surgical treatment of tectal plate gliomas. Methods The clinical data of 9 patients with tectal plate gliomas were analyzed retrospectively. All the patients were microsurgically treated via the occipital- transtentorial approach in 8 patients and the infratentorial-supracerebellar approach in 1. Results Total resection was achieved in all tumors which were diagnosed as low grade gliomas by pathological analysis. After the surgery, difficulties in looking upward of eyes occurred in 1 case. There were no other operative complications and death. The complete remission of hydrocephalus was achieved in 8 patients. The symptoms such as headache and vomiting remained in 1 patient who received endoscopic third ventriculostomy again. All the patients were followed up for 1 to 5 years and MRI showed that no tumor reoccurred. Disorder of ocular movement recovered to different degrees and karnofsky performance scores （KPS） were 90 to 100 in these patients. Conclusions Tectal plate glioma is rare and relatively benign. The active microsurgical treatment can get a good outcome.