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血管母细胞瘤颗粒栓塞术后出血:脊髓和小脑病变的结果比较

Hemorrhage after particle embolization of hemangioblastomas: comparison of outcomes in spinal and cerebellar lesions.

作者信息

Cornelius Jan Frédérick, Saint-Maurice Jean Pierre, Bresson Damien, George Bernard, Houdart Emmanuel

机构信息

Departments of Neurosurgery, Lariboisibre Hospital, Paris, France.

出版信息

J Neurosurg. 2007 Jun;106(6):994-8. doi: 10.3171/jns.2007.106.6.994.

Abstract

OBJECT

In this study the authors compare the clinical outcomes after particle embolization of hemangioblastomas in the cerebellum and spinal cord. They also review the literature of similar cases.

METHODS

Seven patients with hemangioblastomas in the spinal cord (four patients) and cerebellum (three patients) underwent preoperative embolization at the authors' center. Magnetic resonance imaging and selective angiography studies as well as histological diagnoses were available in all patients. Embosphere particles (trisacryl gelatin micro-spheres) were used in all cases. The smallest particle diameter ranged from 100 to 300 microm at the beginning of embolization in all patients. The outcome of embolization was favorable in patients with spinal cord hemangioblastomas, but it was unfavorable for those with cerebellar hemangioblastomas; acute tumor bleeding and death occurred in all of the latter cases. The outcomes following embolization are very different for these two locations possibly because of the different capillary sizes.

CONCLUSIONS

The authors no longer use particle embolization to treat cerebellar hemangioblastomas.

摘要

目的

在本研究中,作者比较了小脑和脊髓血管母细胞瘤颗粒栓塞后的临床结果。他们还回顾了类似病例的文献。

方法

7例脊髓(4例)和小脑(3例)血管母细胞瘤患者在作者所在中心接受了术前栓塞。所有患者均有磁共振成像、选择性血管造影研究以及组织学诊断。所有病例均使用Embosphere颗粒(三丙烯酸明胶微球)。所有患者栓塞开始时最小颗粒直径范围为100至300微米。脊髓血管母细胞瘤患者的栓塞结果良好,但小脑血管母细胞瘤患者的栓塞结果不佳;后者所有病例均发生急性肿瘤出血和死亡。这两个部位栓塞后的结果差异很大,可能是因为毛细血管大小不同。

结论

作者不再使用颗粒栓塞治疗小脑血管母细胞瘤。

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