颅内肿瘤术后脑梗塞25例分析

目的 分析探讨颅内肿瘤手术后脑梗塞的发生原因、机制及其预防措施。方法 总结25例经CT和/或MRI证实的颅内肿瘤术后脑梗塞的发生时间、发生年龄、发生部位及其与颅内肿瘤位置的关系。结果 25例颅内肿瘤术后脑梗塞平均年龄50.5岁,其中21例出现在术后24h内;22例发生于颅底和深部肿瘤手术后;15例位于基底节区。恢复良好20例、症状改善3例、死亡2例。结论 颅内肿瘤术后脑梗塞是由于血管损伤、脑牵拉伤、脑血管痉挛等因素引起脑灌注压下降、脑血管闭塞所致。术中和术后采取积极预防措施可以明显降低脑梗塞的发生率。

Cerebral Infarction Following Operation in 25 Cases with intracranial Tumor

Objective To explore the pathogenetic mechanism and prevention of the cerebral infarction after the operation in the patients with intracranial tumors. Methods A retrospective analysis of data of 25 patients with intracranial tumors, who had cerebral infarction confirmed by CT scanning and/or MRI after the operation, was conducted. The site of infarction, the intervals between the operation and the occurrence of infarction, the clinical manifestations, and the prognosis of these patients were reviewed. Results The infarctions in 21 of the 25 patients were detected within 24 hours after the surgery. The infarctions in 22 cases occurred in the skull bases and the deep area of the brain after the tumor removal, and ones in 15 cases in the region of basal ganglia. Good results were obtained in 20 cases, symptomatic improvement in 3 and death in another 2 cases. Conclusions The occurrence of cerebral infarction after surgery for the brain tumor is usually due to the reduced cerebral perfusion pressure and/or cerebral vascular occlusions caused either by cerebral vascular injury, brain retraction or cerebral vasospasm during the operation. If vigorous preventive measures are adopted during and after the neurosurgery, the postoperative incidence of the cerebral infarction may be significantly reduced.