超声引导下脑沟入路手术治疗大脑中央区病变14例

目的探讨超声引导下脑沟入路手术在治疗大脑中央区病变的应用。方法选择14例大脑中央区病变病人,术中采用超声定位,结合脑沟入路的手术方式切除病变。结果病变全切除10例,近全切除4例。术后病理证实:星形胶质细胞瘤7例,胶质增生1例,海绵状血管瘤4例,转移瘤1例,恶性淋巴瘤1例。原有神经功能障碍8例,术后均有改善。新发神经功能障碍2例,均为运动障碍,出院时完全恢复。未发生术后感染及超声相关的脑损伤。所有病例于术后6个月随访,均无迟发性神经功能障碍。头颅MRI复查9例,未见肿瘤复发。结论超声引导下脑沟入路治疗大脑中央区病变可明显提高手术全切除率,降低术后运动、感觉及语言功能并发症的发生率。

Surgical treatment for lesions in the cerebral central region via transsulcal approach guided by intraoperative ultrasonography:a report of 14 cases

Objective To explore the application of surgical treatment for lesions in the cerebral central region by transsulcal approach guided by ultrasonography.Methods Fourteen patients with lesions in the cerebral central region were operated on lesion resection via transsulcal approach combined with ultrasonographic orientation intraoperatively.Results Total removal of the lesions was achieved in 10 cases and subtotal removal in 4.The lesions were diagnosed by postoperative pathological analysis,including 7 astrocytomas,1 gliosis,4 cavernous angiomas,1 metastasis and 1 malignant lymphoma.The preoperative symptoms of nerve dysfunction were ameliorated in 8 patients.Motor dysfunction occurred,and was cured at discharge in 2 patients.No postoperative infection and brain injury related to ultrasonography occurred.During the follow-up period of 6 months,no delayed nerve dysfunction occurred.Cranial MRI was reperformed in 9 patients and no tumor recurrence was found.Conclusions Surgical treatment for cerebral lesions in the central region via transsulcal approach guided by ultrasonography can obviously increase the complete resection rate,and decrease the complications such as postoperative dysfunction of motor,sensory and language.