脑干海绵状血管瘤的显微手术治疗

目的探讨脑干海绵状血管瘤的诊断和治疗经验。方法本组18例脑干海绵状血管瘤中，病灶位于一侧大脑脚3例，桥脑及桥脑臂9例，桥脑一延髓4例，延髓2例。分别采用经幕下小脑上人路、一侧颞枕小脑幕人路、桥小脑角人路和枕后正巾人路显微手术治疗。结果血管瘤镜下全切17例，次全切除1例。眩晕病人术后症状明显减轻，除1例术后新出现复视外，其余颅神经损害患者症状减轻，或无变化。结论显微手术治疗脑干海绵状血管瘤是可行的，早期手术可能取得较好的效果。

Microsurgery for Brainstem Cavernomas(a Report of 18 Cases)

Objective To explore the diagnosis and microsurgical treatment of the brainstem cavernomas （BSCs）. Methods The clinical data of a series of 18 patients with BSCs managed in our hospital was analyzed retrospectively. Of 18 cases of BSCs, 3 were located in the cerebral peduncles, 9 in the pontes and brachia pontis, 4 in the pontes and medullae oblongata, and 2 in the medullae oblongata. The surgical approaches used during the surgery for BSCs included infratentorial supracerebellar approach, infratempor occipital approach, ponto-eerebellar angle approach and suboccipital midline approach. Results The BSCs were totally resected in 17 patients, and subtotally in 1 patient. The patients with dizziness felt much better after the operation. One patient suffered from diplopia after the operation. The symptoms of cranial nerve injury were relieved or unchanged in 17 patients. The BSCs were confirmed by the postoperative pathological examination in all the patients. Conclusions Surgical removal of BSCs is feasible. Early mierosurgery may be helpful to improvement of prognoses patients with BSCs.