第四脑室肿瘤的显微外科治疗

目的总结第四脑室肿瘤的显微外科治疗效果及手术策略。方法第四脑室肿瘤患者36例，均在显微镜下或神经内镜辅助下切除肿瘤。肿瘤全切除24例，次全切除12例。结果术后恢复良好13例，死亡3例，缄默症4例，脑积水16例，其中12例行侧脑室．腹腔分流术，4例行脑室心房分流术。术后随访：29例生活、学习良好，3例死亡，1例失访。结论正确及时的诊断、熟悉四脑室的显微解剖、选择合适的手术入路、熟练的显微手术技巧、适当应用神经内镜、积极处理术后脑积水是提高第四脑室肿瘤疗效的关键。

Microsurgical treatment of the fourth ventricle tumor

Objective To study the curative effect of minimally invasive surgical intervention for the fourth ventricles tumor. Methods Of 36 patients with the fourth ventricle tumor, 24 received total resection of the tumors and 12 subtotal. The tumors were exsected through the posterior cranial fossa central suboccipital approach under the microscope or neuroendoscopies. Results Of 36 patients, 13 recovered well, 3 died, mutism in 4, hydrocephalus in 16, among them, 12 were performed with lateral cerebral ventricle-peritoneal shunt and ventriculoatrial shunt in 4. All patients were followed up except one patient,29 recovered well and 3 died. Conclusions The corrected and prompted diagnosis, understanding of microanatomy, optimal operative approach, skillful microsurgical skill,using of the neuroendoscopies and active treatment of hydrocephalus are the key points to improving the curative effects for treatment of the fourth ventricle tumor.