第四脑室神经鞘瘤的临床特点及手术治疗并文献复习

目的探讨原发性第四脑室神经鞘瘤的临床特征及手术方法。方法分析1例原发性第四脑室神经鞘瘤手术治疗患者的临床资料,并结合文献分析该病的临床特点和手术方法。结果患者为女性,53岁,表现为剧烈头痛、吞咽困难、共济失调、四肢无力等症状,影像学示第四脑室巨大肿瘤,合并脑积水。手术采用经枕下正中小脑延髓裂入路,肿瘤镜下获得全切除,术后病理诊断为神经鞘瘤。术后随访8个月,未见肿瘤复发。结论尽管脑室内神经鞘瘤罕见,且诊断困难,但该类型肿瘤为良性肿瘤,其边界清楚。因此,手术若能获得有效的全切除,远期预后良好。

Clinical characteristics,surgical treatment and literature review of fourth ventricular schwannoma

Objective To investigate the clinical characteristics and surgical methods of primary fourth ventricle schwannoma .Methods The clinical data of one rare case with solitary primary fourth ventricle schwannoma was analyzed retrospectively .The clinical characteristics and surgical methods combining with documents review were discussed .Results The patient was a 53-year-old female, manifested as severe headache , difficulty swallowing , ataxia, weakness.The imaging studies showed a huge fourth ventricle tumor with hydrocephalus .The tumor was removed through midline suboccipital craniotomy and transcerebellomedullary fissure approach .Complete removal was achieved and no reccurrence was noted in 8 months after surgery .Histopathological examination confirmed the diagnosis of schwannoma .Conclusions Although intraventricular schwannomas are rare tumors and the preoperatively diagnosis is difficult , it is benign and well-circumscribed neoplasms .Total resection is curative , and the long-term prognosis is good .