Kornienko V N, Amcheslavskiĭ V G, Bragina N N, Barkalaia D B, Lobanov S A, Korshunov A G, Smirnova I A
Zh Vopr Neirokhir Im N N Burdenko. 1991 May-Jun(3):13-6.
The authors analyse the results of clinico-CT studies in complicated course of the early postoperative period in 104 patients (87 adults and 17 children) with tumors of the posterior cranial fossa (PCF). According to the histological structure and predominant topography of the neoplasm, the cases were divided into 46 extracerebral parastem tumors (meningiomas, neurinomas, chordomas, cholesteatomas) among which 24 extended supratentorially and 22 to Blumenbach's clivus; 23 gliomas of the cerebellum and fourth ventricle; 16 primary gliomas of the stem; 19 other new growths (hemangioblastomas, hamartomas, choroid papillomas, germinomas). A common factor was coexistence of the main complicating condition--circulatory disorder in the stem with edema and dislocation of the stem, disturbed spatial relations between the PCF structures. Dynamic CT studies allowed the authors to differentiate 3 main variants of pathological changes differing in the character of cerebral circulatory disorders: 1st--a wide zone of reduced density in the brain stem; the extent of this zone in the orocaudal direction and its relation to the diameter of the stem (dorsal, ventral, lateral parts) varied; 2nd--combination of zones of reduced density in the stem and cerebellum with hemorrhagic inclusions--multiple "punctate" inclusions or in the form of blood clots; 3rd--in mosaic pattern of the ischemic foci in the stem and cerebellum there was a prevalence of hemorrhages in the form of multiple small extravasations of blood at different levels of the stem, in the subcortical parts, blood clots in the seat of the tumor, hemotamponade of the brain ventricles.(ABSTRACT TRUNCATED AT 250 WORDS)
作者分析了104例（87例成人和17例儿童）后颅窝（PCF）肿瘤患者术后早期复杂病程的临床CT研究结果。根据肿瘤的组织结构和主要部位，病例分为46例脑外旁矢状肿瘤（脑膜瘤、神经鞘瘤、脊索瘤、胆脂瘤），其中24例向上扩展至幕上，22例至Blumenbach斜坡；23例小脑和第四脑室胶质瘤；16例脑干原发性胶质瘤；19例其他新生物（血管母细胞瘤、错构瘤、脉络丛乳头状瘤、生殖细胞瘤）。一个共同因素是主要并发症——脑干循环障碍伴脑干水肿和移位，后颅窝结构之间的空间关系紊乱。动态CT研究使作者能够区分3种主要的病理变化类型，这些类型在脑循环障碍的特征上有所不同：第一——脑干密度降低的广泛区域；该区域在口尾方向的范围及其与脑干直径（背侧、腹侧、外侧部分）的关系各不相同；第二——脑干和小脑中密度降低区域与出血性内含物的组合——多个“点状”内含物或以血凝块形式存在；第三——脑干和小脑中缺血灶呈镶嵌模式，在脑干不同水平、皮质下部分有多处小出血形式的出血占优势，肿瘤部位有血凝块，脑室受压。（摘要截于250字）
