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儿童哑铃型三叉神经鞘瘤:经翼点入路一期手术完整切除

Dumbbell trigeminal schwannoma in a child: complete removal by a one-stage pterional surgical approach.

作者信息

Verstappen C C P, Beems T, Erasmus C E, van Lindert E J

机构信息

Department of Neurology, University Medical Center St Radboud, Nijmegen, The Netherlands.

出版信息

Childs Nerv Syst. 2005 Nov;21(11):1008-11. doi: 10.1007/s00381-004-1091-3. Epub 2005 Mar 16.

Abstract

OBJECTIVE

The objective was to describe a rare case of a trigeminal schwannoma in a child and the surgical procedure performed for therapy.

PATIENT AND METHODS

A 6-year-old girl presented with tiredness, dysarthric speech and cerebellar symptoms. Imaging studies revealed a unilateral dumbbell-shaped tumour, extending into both the middle and posterior fossa, centred over Meckel's cave. One-stage surgery was performed by pterional craniotomy. The tumour was first debulked in the middle fossa, then peeled from the wall of the cavernous sinus, followed by extirpation of the tumour from the posterior fossa. The tumour extended to the caudal cranial nerves and was completely removed. Trigeminal fascicles were distributed throughout the tumour. Histopathological examination revealed a schwannoma.

CONCLUSION

Trigeminal schwannoma is a tumour that occurs rarely in childhood. Although several, often multistaged surgical strategies have been reported in the literature, this tumour was eradicated by a one-stage pterional approach.

摘要

目的

描述1例儿童三叉神经鞘瘤的罕见病例及为治疗而实施的手术过程。

患者与方法

一名6岁女孩出现疲倦、构音障碍和小脑症状。影像学检查显示一个单侧哑铃形肿瘤,延伸至中颅窝和后颅窝,以 Meckel腔为中心。通过翼点入路进行一期手术。肿瘤先在中颅窝进行瘤内切除,然后从海绵窦壁上剥离,接着从后颅窝切除肿瘤。肿瘤延伸至尾侧颅神经并被完全切除。三叉神经束分布于整个肿瘤。组织病理学检查显示为神经鞘瘤。

结论

三叉神经鞘瘤是一种在儿童期罕见发生的肿瘤。尽管文献中报道了几种通常为多阶段的手术策略,但该肿瘤通过一期翼点入路得以根除。

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