颅内脑膜瘤颗粒栓塞后的神经并发症
Neurologic complications after particle embolization of intracranial meningiomas.
作者信息
Bendszus Martin, Monoranu Camelia Maria, Schütz Ansgar, Nölte Ingo, Vince Giles H, Solymosi László
机构信息
Department of Neuroradiology, University of Würzburg, Germany.
出版信息
AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1413-9.
BACKGROUND AND PURPOSE
Preoperative embolization of meningiomas is frequently used to facilitate surgery and to reduce intraoperative blood loss. The purpose of this study was to evaluate the frequency of procedure-related neurologic complications during and after particle embolization of intracranial meningiomas.
METHODS
Between 1996 and 2004, 185 consecutive patients underwent particle embolization of an intracranial meningioma. Devascularization was performed by means of superselective probing of the tumor-feeding vessels and ensuing free-flow embolization with spherical particles. All procedures were performed with systemic heparinization.
RESULTS
Six patients (3.2%) had ischemic events with neurologic deficit. Two had amaurosis, and four patients presented with hemiparesis. Hemorrhage occurred in six patients (3.2%). In five of these patients, rapid microsurgical tumor removal resulted in a favorable outcome without persistent neurologic deficit. In one patient, massive intratumoral, subarachnoid, and subdural hemorrhage was lethal.
CONCLUSION
Particle embolization of meningiomas is associated with a substantial risk of ischemic and hemorrhagic events. The individual risk-to-benefit ratio of embolization should be thoroughly considered.
背景与目的
脑膜瘤术前栓塞术常用于辅助手术并减少术中失血。本研究旨在评估颅内脑膜瘤颗粒栓塞术期间及术后与手术相关的神经系统并发症的发生率。
方法
1996年至2004年期间，185例连续患者接受了颅内脑膜瘤颗粒栓塞术。通过对肿瘤供血血管进行超选择性探查并随后用球形颗粒进行自由流动栓塞来实现血管减容。所有手术均在全身肝素化下进行。
结果
6例患者（3.2%）发生缺血性事件并伴有神经功能缺损。2例出现黑矇，4例出现偏瘫。6例患者（3.2%）发生出血。其中5例患者通过快速显微手术切除肿瘤获得了良好的预后，且无持续性神经功能缺损。1例患者因肿瘤内、蛛网膜下腔和硬膜下大量出血死亡。
结论
脑膜瘤颗粒栓塞术与缺血性和出血性事件的重大风险相关。应充分考虑栓塞术的个体风险效益比。
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