小脑海绵状血管瘤的手术治疗

目的小脑海绵状血管瘤较少见，通过回顾分析手术的11例小脑海绵状血管瘤的临床资料，探讨其临床特征、放射学表现以及手术策略。方法11例小脑海绵状血管瘤中男性3例，女性8例（男：女=1：2．7）；年龄17～74岁，平均40岁；临床均为急性发病，以头痛、小脑症状为主；所有患者均行CT和MRI扫描，9例为ZabramskiⅡ型，2例属Ⅰ型；4例术前全脑血管造影，2例发现合并静脉畸形。结果所有患者均采用常规枕下入路，均全切病变，无手术死亡，无手术相关并发症，随访期内无再出血，无病变复发。结论dqg海绵状血管瘤具有独立于后颅窝其他部位的海绵状血管瘤的特征，常急性起病，与其他部位的海绵状血管瘤相比，年龄、性别没有差异，外科治疗安全有效。

Neurosurgical management of cerebellar cavernous malformations

Objective To analyze cerebellar cavernous malformations with respect to clinical, radiological, and therapeutic aspects, by retrospective analysis. Methods Eleven patients whose lesions were located in the cerebellum were retrospectively reviewed. There were 3 male and 8 female patients （ 1 ： 2.7） aged from 17 to 74 years （mean age 40 years）. Clinical presentation, including headache, the symptoms and signs of cerebellar, was sudden or acute in all cases. Neuroimaging examinations （CT and MRI） perfornaed in all patients： nine cases were type Ⅱ and 2 cases were type Ⅰ according to the classification of Zabramski. Results All the patients were operated by standard suboccipital approach. The mean size of malformations was 3.1 cm and all of the lesions were totally removed without complications. After a mean follow-up period of 56 months, all patients were considered to be in good or excellent clinical condition. Conclusion Cerebellar cavernous malformations should be analyzed separately from other posterior fossa cavernous malformations. These lesions can be in large size and cause massive hemorrhage, resulting in acute or sudden presentation. Surgery is a safe and effective option that provides a curative treatment when a complete removal is achieved.