Cascino G D, Kelly P J, Hirschorn K A, Marsh W R, Sharbrough F W
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1990 Aug;65(8):1053-60. doi: 10.1016/s0025-6196(12)62716-5.
We performed a retrospective study of stereotactic resections of intra-axial brain mass lesions in 30 patients with intractable partial epilepsy. The most common pathologic alterations observed were vascular malformations (11 lesions) and glial neoplasms (11 lesions). The locations of the lesions included the postcentral gyrus in five patients, the precentral gyrus in five, and the deep-seated left posterior temporal region in four, all of which were sites that may have precluded standard craniotomy and cortical resection. Of the 30 medically refractory patients, 26 had at least an 80% reduction in seizure activity at a mean duration of follow-up of 22 months postoperatively. Nineteen of 22 patients with at least 1 year (mean, 28 months) of follow-up and 13 of 15 patients with at least 2 years (mean, 34 months) of follow-up had favorable surgical outcomes. "Lesionectomy" may allow pathologic examination of intracranial lesions and may produce a worthwhile reduction in seizure activity in some patients with intractable partial epilepsy.
我们对30例难治性部分性癫痫患者的脑内轴性肿块病变进行了立体定向切除术的回顾性研究。观察到的最常见病理改变是血管畸形（11个病变）和神经胶质瘤（11个病变）。病变部位包括5例患者的中央后回、5例患者的中央前回以及4例患者的深部左侧颞叶后部区域，所有这些部位可能都无法进行标准开颅和皮质切除术。在30例药物难治性患者中，26例在术后平均22个月的随访期间癫痫活动至少减少了80%。在22例至少随访1年（平均28个月）的患者中，19例手术效果良好；在15例至少随访2年（平均34个月）的患者中，13例手术效果良好。“病损切除术”可能有助于对颅内病变进行病理检查，并且可能使一些难治性部分性癫痫患者的癫痫活动得到有价值的减少。
