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儿童脑海绵状血管瘤的外科治疗

Surgical management of brain cavernomas in children.

作者信息

Alexiou George A, Mpairamidis Evriviadis, Sfakianos George, Prodromou Neofytos

机构信息

Department of Neurosurgery, Children's Hospital Agia Sofia, Athens, Greece.

出版信息

Pediatr Neurosurg. 2009;45(5):375-8. doi: 10.1159/000260907. Epub 2009 Nov 26.

Abstract

BACKGROUND

Cavernous hemangiomas are benign vascular hamartomas caused by developmental malformations of the vascular bed. They can be found in 0.3-0.7% of the population, whereas one fourth of these lesions occur in children.

METHODS

In the present study, we report on 16 cases of cavernomas surgically treated in our institute. From each patient's file, the age, sex, lesion location, symptoms and follow-up were analyzed.

RESULTS

The most commonly presenting symptom was epilepsy. Radiological signs of acute hemorrhage were observed in 3 cases. Three children had multiple cavernomas. The parietal lobe was the most common site of occurrence, whereas only 2 cavernomas were infratentorial. There was no operative mortality. Postoperatively, there was no additional neurological deficit, and all patients gradually improved. In a case of pontine cavernoma, there was a need for reoperation due to rebleeding.

CONCLUSION

With the improvement of microsurgical techniques and modern neuroimaging, nearly all cavernomas can be safely removed. Total resection is associated with patients' clinical improvement and seizure control.

摘要

背景

海绵状血管瘤是由血管床发育畸形引起的良性血管错构瘤。人群中其发病率为0.3%-0.7%,其中四分之一的病例发生于儿童。

方法

在本研究中,我们报告了我院手术治疗的16例海绵状血管瘤病例。分析了每位患者的年龄、性别、病变部位、症状及随访情况。

结果

最常见的症状是癫痫。3例观察到急性出血的影像学征象。3名儿童患有多发性海绵状血管瘤。顶叶是最常见的发病部位,而仅2例海绵状血管瘤位于幕下。无手术死亡病例。术后无新增神经功能缺损,所有患者均逐渐好转。1例脑桥海绵状血管瘤因再出血需要再次手术。

结论

随着显微外科技术和现代神经影像学的进步,几乎所有海绵状血管瘤都能被安全切除。全切与患者临床症状改善及癫痫控制相关。

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