【摘要】 目的探讨脑干海绵状血管瘤的显微外科治疗及预后。方法对23例脑干海绵状血管瘤患者的临床资料进行回顾性分析。所有患者均接受显微外科治疗，病灶给予全切。结果无手术死亡病例。18例术后神经功能障碍比术前明显改善;2例术后神经功能缺失进一步加重，但在术后随访期间，神经功能已恢复至术前状态;3例术后症状无改善。经平均38个月随访，均未见病变复发。结论脑干海绵状血管瘤表现为进行性神经功能缺失，具有占位效应，接近脑干表面者可考虑手术治疗。掌握适当手术指征和微创技术，脑干海绵状血管瘤可通过手术切除，预后良好。
【关键词】 脑干; 血管瘤; 海绵状; 显微外科
Analysis on Microsurgical treatment and outcome of brainstem
cavernous hemangioma in 23 casesMaimaitili·Mijiti, Askar, CHENF Xiaojiang, et al
(Department of Neurosurgery, First Affiliated Hospital, Xinjiang Medical University,
Urumqi 830011, China) Abstract: ObjectiveTo analyze the Microsurgical treatment and outcome of brainstem cavernous hemangioma in 23 cases. MethodsThe clinical records of 23 patients with brainstem cavernous hemangioma were retrospective reviewed. ResultsAmong the 23 cases, 5 cases were situated in themesencephalon, 3 cases in pontomesencephalicjunction, 12 cases in pons, 1 case in pontomedullary junction and 2 cases in medulla oblongata. All of the patients were undergone microsurgical treatment ,and cavernous hemangiomas were totally removed from all patients. There is no operative mortality. Neurological deficits were improved in 18 cases after operation. Neurological conditions worsen transiently in 2 cases which returned to the preoperative status during followup. 3 cases shown unchanged after operation. ConclusionsBrain stem cavernous hemangioma, which exhibited progressive neural function deficits, mass effect and superficial location of the brain stem should be considered as a good candidate for microsurgical therapy. Minimally invasive techniques and careful operative planning may contribate to the treatment of cavernous hemangioma involving the brain stem.
Key words: brain stem; hemangioma; cavernous; microsurgery海绵状血管瘤是一种血管畸形，占颅内血管畸形的5%～16%，其中18%～22%的颅内症状性海绵状血管瘤发生于脑干[12]。脑干是海绵状血管瘤的相对好发部位，尤以桥脑比例最高;脑干海绵状血管瘤(brainstem cavernous hemangioma, BCH)较其他部位海绵状血管瘤更容易发生瘤内出血，BCH的自然史尚不清楚，一旦有症状，其临床进展很快，再出血
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