Ryken T C, Hitchon P W, Roach R M, Traynelis V C
Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City.
Stereotact Funct Neurosurg. 1992;59(1-4):111-4. doi: 10.1159/000098926.
A review of the stereotactic cases performed at the University of Iowa between February, 1985, and December, 1990, yielded 12 infratentorial stereotactic biopsies in 11 patients. A definitive diagnosis was obtained in 9 of 11 patients. One patient required a second biopsy to obtain a diagnosis and 1 yielded cystic fluid only. The pathological diagnosis obtained included 4 high-grade gliomas, 2 undifferentiated adenocarcinomas, 2 low-grade astrocytomas, 1 malignant ependymoma, 1 pontine hematoma and 1 cyst. None of the patients experienced increased neurological deficit following biopsy and there was no mortality. One patient developed postoperative meningitis. We conclude that stereotactic biopsy of infratentorial lesions can be performed safely with a high probability of obtaining a diagnosis. Adequate tissue diagnosis is necessary to direct further therapy.
回顾1985年2月至1990年12月在爱荷华大学进行的立体定向手术病例,11例患者中有12例幕下立体定向活检。11例患者中有9例获得了明确诊断。1例患者需要再次活检以明确诊断,1例仅抽出囊性液体。病理诊断包括4例高级别胶质瘤、2例未分化腺癌、2例低级别星形细胞瘤、1例恶性室管膜瘤、1例脑桥血肿和1例囊肿。所有患者活检后均未出现神经功能缺损加重,也无死亡病例。1例患者发生术后脑膜炎。我们得出结论,幕下病变的立体定向活检可以安全进行,且获得诊断的概率很高。充分的组织诊断对于指导进一步治疗是必要的。