Ohta Y, Nariai T, Ishii K, Ishiwata K, Senda M, Okeda R, Ohno K, Hirakawa K
Department of Neurosurgery, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Acta Neurochir (Wien). 2003 Jul;145(7):587-90; discussion 590-1. doi: 10.1007/s00701-003-0047-9.
A 17-year-old boy with epileptic seizures due to meningio-angiomatosis without neurofibromatosis type 2 is presented. Low grade astrocytoma in the left temporal lobe was resected when he was 11 years old. A recurrence was suspected on following-up MRI and a positive PET scan with 11C-methionine PET 6 years later around the resected area. The language area was mapped using H2(15)O PET activation technique. The lesion was completely resected while preserving the verbal area assisted by three-dimensional imaging protocol of MR-registered PET. The patient was well and seizure-free for 8 years thereafter without antiepileptic drugs. Histologically, there was an increase of dilated arterioles and meningothelial cell-like spindle cells around them, which are characteristic pathological features of meningio-angiomatosis. It is most likely that angiomatous tissue developed perivascular meningiomatous components and formed the meningio-angiomatosis in our presented case. In addition, we presented our protocol of functional neuro-imaging which was useful in terms of the functional neurosurgery.
本文报告了一名17岁因脑膜血管外皮细胞瘤导致癫痫发作且无2型神经纤维瘤病的男孩。他11岁时，左颞叶的低级别星形细胞瘤被切除。随访MRI怀疑复发，6年后在切除区域周围进行的11C-蛋氨酸PET扫描显示阳性。使用H2(15)O PET激活技术对语言区域进行了定位。在MR配准PET的三维成像协议辅助下，在保留语言区域的同时将病变完全切除。此后患者状况良好，8年未服用抗癫痫药物且无癫痫发作。组织学上，扩张的小动脉及其周围的脑膜内皮细胞样梭形细胞增多，这是脑膜血管外皮细胞瘤的特征性病理表现。在我们的病例中，血管性组织很可能发展为血管周围脑膜瘤成分并形成了脑膜血管外皮细胞瘤。此外，我们还展示了我们的功能神经成像方案，该方案在功能神经外科方面很有用。
