Pérez-Gómez José L, Rodríguez-Alvarez Carlos A, Marhx-Bracho Alfonso, Rueda-Franco Fernando
Departamento de Neurocirugía Pediátrica, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Col. Insurgentes Cuicuilco, Deleg. Coyoacán, Mexico.
Childs Nerv Syst. 2010 Jan;26(1):29-34. doi: 10.1007/s00381-009-1000-x. Epub 2009 Sep 26.
Our aim is to describe clinical and paraclinical features in patients who underwent stereotactic-guided biopsy for brainstem tumors.
A study of case series was made by reviewing the records of patients who underwent stereotactic biopsy for brainstem tumors.
Stereotactic biopsy for brainstem tumors was performed (between 2000 and 2008) in 20 children (11 girls, and 9 boys), mean age 7.95 +/- 3.12 years at the time of diagnosis. The mean time from onset of symptoms to diagnosis was 6.59 +/- 13.58 months (0.50-60 months). The most frequent symptoms and signs at onset were related to disturbance of cerebellar function and cranial nerve nuclei. Location was pontomesencephalic (35%), pontine (30%), pontomedullar (25%), and in the whole brainstem (10%). The most common type of image was intrinsic-diffused (55%). The histopathology was anaplastic astrocytoma (30%), followed by fibrillary and pilocytic types (25% each), low-grade astrocytoma (5%), high-grade astrocytoma (5%), and normal tissue (10%). Mild complications were observed in only two cases.
Stereotactic biopsy done for clarifiying a diagnostic imaging in brainstem tumors is important in obtaining a definitive diagnosis with a low rate of complications.
我们的目的是描述接受脑干肿瘤立体定向活检的患者的临床和辅助检查特征。
通过回顾接受脑干肿瘤立体定向活检患者的记录进行病例系列研究。
（2000年至2008年期间）对20名儿童（11名女孩和9名男孩）进行了脑干肿瘤立体定向活检，诊断时平均年龄为7.95±3.12岁。从症状出现到诊断的平均时间为6.59±13.58个月（0.5至60个月）。发病时最常见的症状和体征与小脑功能和颅神经核功能障碍有关。病变部位为脑桥中脑（35%）、脑桥（30%）、脑桥延髓（25%）和整个脑干（10%）。最常见的影像学类型为弥漫性（55%）。组织病理学检查结果为间变性星形细胞瘤（30%），其次是纤维型和毛细胞型（各25%）、低级别星形细胞瘤（5%）、高级别星形细胞瘤（5%）和正常组织（10%）。仅两例观察到轻度并发症。
为明确脑干肿瘤的诊断性影像学而进行的立体定向活检对于获得确诊且并发症发生率低具有重要意义。
