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前庭神经海绵状血管瘤:病例报告及文献综述

Cavernous angioma of the vestibular nerve: case report and literature review.

作者信息

Adachi Kazuhide, Yoshida Kazunari, Akiyama Takekazu, Kawase Takeshi

机构信息

Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Surg Neurol. 2008 Jul;70(1):82-6; discussion 86. doi: 10.1016/j.surneu.2007.04.008. Epub 2008 Feb 11.

Abstract

BACKGROUND

To date, 50 cases of cavernous angioma in the CPA have been reported, and previous reports did not describe the tumor's site of origin. We describe a case of a small, extraaxial cavernous angioma of the vestibular nerve. We also propose a reclassification system for cavernous angioma of the CPA based on the tumor's site of origin.

CASE DESCRIPTION

A 39-year-old female patient had recurrent deteriorating vertigo and a right hearing disturbance. Magnetic resonance imaging revealed a cavernous angioma of the right CPA. Surgery was performed through a right lateral suboccipital approach. In the present case, the mass was attached to and covered the cisternal portion of the vestibular nerve, and it contained microvessels that were fed from the vascular plexus of the vestibular nerve. The tumor was resected en bloc, and the microvessels feeding it were cauterized.

CONCLUSIONS

On the basis of our review of 50 cases of cavernous angioma of the CPA, we propose that these tumors can be classified according to whether they develop from the venous plexus of the dura matter or of a cranial nerve. We also suggest that the site of origin affects the postoperative symptoms.

摘要

背景

迄今为止,已报道了50例小脑脑桥角海绵状血管瘤病例,既往报道未描述肿瘤的起源部位。我们描述了1例起源于前庭神经的小脑脑桥角外侧型小海绵状血管瘤病例。我们还基于肿瘤的起源部位提出了一种小脑脑桥角海绵状血管瘤的重新分类系统。

病例描述

一名39岁女性患者反复出现眩晕加重及右耳听力障碍。磁共振成像显示右侧小脑脑桥角海绵状血管瘤。通过右侧枕下外侧入路进行手术。在本病例中,肿块附着并覆盖前庭神经的脑池段,且含有从前庭神经血管丛供血的微血管。肿瘤被整块切除,并烧灼了为其供血的微血管。

结论

基于我们对50例小脑脑桥角海绵状血管瘤病例的回顾,我们提出这些肿瘤可根据其是否起源于硬脑膜静脉丛或脑神经静脉丛进行分类。我们还认为起源部位会影响术后症状。

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