Zúccaro Graciela, Sosa Fidel
Department of Neurosurgery, Hospital Nacional de Pediatria Juan P. Garrahan, Buenos Aires, Argentina.
Childs Nerv Syst. 2007 Feb;23(2):177-83. doi: 10.1007/s00381-006-0208-2. Epub 2006 Oct 28.
Cerebellopontine angle (CPA) lesions are more commonly found in adults in which they account for 5-10% of all intracranial tumors. However, they are uncommon in children, with an incidence of only 1%.
This is a review of the management of CPA lesions in children admitted to the Hospital Nacional de Pediatría "Profesor Doctor Juan P. Garrahan" (Argentine National Pediatrics Hospital "Professor Juan P. Garrahan") between January 1988 and December 2003.
The series included 30 children with 33 CPA lesions, 20 arising from the subarachnoid space of the CPA and 13 from the vicinity and growing mainly into the CPA. Twenty-seven tumors were located in the left CPA (82%) and six (12%), on the right. Ten of the 30 patients developed hydrocephalus, but only three of these required treatment. All patients underwent retrosigmoid suboccipital craniotomy and microsurgical resection. Gross total removal was achieved in 12 cases, subtotal in 18, and fenestration of the cyst wall in the three arachnoid cysts. Ten patients have no sequelae, ten have mild deficit, three have severe deficits, and seven have died.
The CPA is a rare location for lesions in children, with clear predominance on the left side. Benign lesions are more frequent. Even though schwannoma is the most frequently found lesion, the histology varies widely.
桥小脑角(CPA)病变在成人中更为常见,占所有颅内肿瘤的5% - 10%。然而,它们在儿童中并不常见,发病率仅为1%。
这是一篇对1988年1月至2003年12月间入住阿根廷国家儿科医院“胡安·P·加拉汉教授医院”的儿童CPA病变治疗情况的综述。
该系列包括30例患有33个CPA病变的儿童,其中20个起源于CPA的蛛网膜下腔,13个起源于其附近并主要向CPA生长。27个肿瘤位于左侧CPA(82%),6个(12%)位于右侧。30例患者中有10例出现脑积水,但其中只有3例需要治疗。所有患者均接受了乙状窦后枕下开颅和显微手术切除。12例实现了全切,18例次全切,3个蛛网膜囊肿行囊肿壁开窗术。10例患者无后遗症,10例有轻度功能缺损,3例有严重功能缺损,7例死亡。
CPA是儿童病变的罕见部位,明显以左侧居多。良性病变更为常见。尽管神经鞘瘤是最常见的病变,但组织学差异很大。