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脊髓海绵状畸形:5例报告

Spinal cavernous malformations: a report of 5 cases.

作者信息

Cansever Tufan, Civelek Erdinc, Sencer Altay, Karasu Aykut, Kiriş Talat, Hepgül Kemal, Can Halil, Canbolat Ali

机构信息

Neurosurgery Department, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.

出版信息

Surg Neurol. 2008 Jun;69(6):602-7; discussion 607. doi: 10.1016/j.surneu.2007.01.074. Epub 2008 Mar 4.

Abstract

BACKGROUND

This is a report of 5 patients treated surgically for SCMs.

METHODS

During the period from 1998 to 2003, 5 patients (4 male and 1 female) harboring SCMs were treated surgically (all of them underwent complete surgical removal). Patients' ages ranged between 22 and 57 years (mean age, 46 years). Median duration of symptoms was 31 months (1-120 months). Diagnosis was made by MRI scan showing lesions in length of 1 to 6 cm in diameter (mean length, 2.9 cm). Three lesions were found in the cervical, one in the upper dorsal, and one in the lower dorsal cord. One of them was located extradurally, one of them intradural extramedullary, and 3 of them intramedullary.

RESULTS

An MRI examination showing total removal was performed postoperatively in each patient (the postoperative MRI examinations revealed total removal in all cases). The follow-up period ranged from 1 to 4 years (mean, 27 months). All patients showed clinical improvement, with 3 of them worsening early in the postoperative period but doing better in long-term follow-up (although 3 of 5 patients had worse neurological examinations in the early postoperative period, all recovered in long-term follow-up and clinically improved relative to preoperative status).

CONCLUSION

Neurological status of the patients can worsen in the early postoperative period, causing intramedullary operation; but it usually improves relative to preoperative status. Surgical removal seems to be a safe and a promising way of treatment of symptomatic SCMs.

摘要

背景

本文报告5例经手术治疗的脊髓海绵状血管瘤(SCMs)患者。

方法

1998年至2003年期间,5例患有脊髓海绵状血管瘤的患者接受了手术治疗(均接受了完整的手术切除)。患者年龄在22至57岁之间(平均年龄46岁)。症状的中位持续时间为31个月(1至120个月)。通过MRI扫描确诊,显示病变直径为1至6厘米(平均长度2.9厘米)。3个病变位于颈部脊髓,1个位于上胸段脊髓,1个位于下胸段脊髓。其中1个位于硬膜外,1个位于硬膜下髓外,3个位于髓内。

结果

术后对每位患者进行了显示肿瘤完全切除的MRI检查(术后MRI检查显示所有病例均实现了完全切除)。随访期为1至4年(平均27个月)。所有患者临床症状均有改善,其中3例在术后早期症状加重,但在长期随访中情况好转(尽管5例患者中有3例在术后早期神经功能检查结果较差,但在长期随访中均恢复,且相对于术前状态临床症状有所改善)。

结论

患者的神经功能状态在术后早期可能会恶化,这是髓内手术造成的;但通常相对于术前状态会有所改善。手术切除似乎是治疗有症状脊髓海绵状血管瘤的一种安全且有前景的方法。

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