Nagib Mahmoud G, O'Fallon M Therese
Neurosurgical Associates Ltd., Minneapolis, MN 55407, USA.
Pediatr Neurosurg. 2002 Feb;36(2):57-63. doi: 10.1159/000048354.
The authors have reviewed available data from 7 pediatric patients with intramedullary spinal cord cavernous angioma (ISCCA) reported in the literature, and added from their own series 2 pediatric patients, for a total of 9 patients. This group of pediatric patients' clinical presentation, course, management and outcome were compared to their adult counterparts as reported in the literature. In contrast to adults, children with symptomatic ISCCA do not show a gender imbalance and the thoracic spinal cord is not predominantly involved. Pediatric patients commonly present with an acute episode and rapid deterioration. A more favorable outcome has been reported in children as compared to adults in the face of relatively similar presenting deficits. As in adults, magnetic resonance imaging (MRI) remains the diagnostic and postoperative test of choice. Complete resection affords the best chance for cure. Symptomatic children with ISCCA characteristically present with an acute deficit and rapid deterioration. MRI of the entire neuraxis is recommended for lesion multiplicity. An attempt at total resection and long-term MRI follow-up are recommended.
作者回顾了文献中报道的7例小儿脊髓髓内海绵状血管瘤(ISCCA)患者的现有数据,并将自己系列中的2例小儿患者纳入,共计9例患者。将这组小儿患者的临床表现、病程、治疗及结果与文献中报道的成人患者进行了比较。与成人不同,有症状的小儿ISCCA患者不存在性别失衡,且胸段脊髓并非主要受累部位。小儿患者通常表现为急性发作和快速恶化。在面对相对相似的表现缺陷时,与成人相比,小儿患者的预后更有利。与成人一样,磁共振成像(MRI)仍然是诊断和术后首选的检查方法。完全切除提供了最佳的治愈机会。有症状的小儿ISCCA患者典型地表现为急性功能缺损和快速恶化。建议对整个神经轴进行MRI检查以评估病变的多发性。建议尝试进行全切并进行长期MRI随访。