Che Xiao-ming, Xu Qi-wu, Shou Jia-jun, Gu Shi-xin, Zhang Ming-guang, Sun Bing, Cui Da-ming
Department of Neurosurgery, Hualshan Hospital, Fudan University, Shanghai 200040, China.
Zhonghua Yi Xue Za Zhi. 2008 May 20;88(19):1306-8.
The clinical diagnosis and surgical management of intramedullary spinal cord cavernous angioma were discussed.
Total 19 patients with intramedullary cavernous angioma were analyzed retrospectively on the clinical manifestation, radiographic feature, diagnosis and differentiation, surgical technique and caution. Of all the 19 patients, averaging 38.7 years old, 14 were male and 5 were female. Nine patients were followed.
All the 19 patients pathologically diagnosed with spinal cord cavernous angioma got good surgical results, besides one patient showed loss of proprioception. Nine patients were followed up and all demonstrated improvement on neurological function.
The clinical symptom of most of the patients with spinal cord cavernous angioma presented mildly at onset, but deteriorated gradually because of repeated prehemorrhage. Since the lesion showed some characteristic in MRI, MRI examination was regarded as an important diagnostic tool. Dissection should be done between the tumor and the gliosis during the surgical procedure, special attention should be paid to avoiding tumor residual. It was not necessary to aggressively evacuate the hematoma derived from tumor hemorrhage, which extended along the central canal up and down, except obvious occupied syndrome exited.
探讨脊髓髓内海绵状血管瘤的临床诊断及手术治疗方法。
回顾性分析19例脊髓髓内海绵状血管瘤患者的临床表现、影像学特征、诊断与鉴别诊断、手术技巧及注意事项。19例患者平均年龄38.7岁，男性14例，女性5例。9例患者获得随访。
19例经病理诊断为脊髓海绵状血管瘤的患者手术效果良好，仅1例患者出现本体感觉丧失。9例患者获得随访，神经功能均有改善。
多数脊髓海绵状血管瘤患者起病时临床症状较轻，但因反复少量出血而逐渐加重。由于病变在磁共振成像（MRI）上有一定特征性表现，故MRI检查是重要的诊断手段。手术中应在肿瘤与胶质增生带之间进行分离，特别注意避免肿瘤残留。对于肿瘤出血沿中央管上下蔓延形成的血肿，除非有明显占位效应，不必强行清除。
