Department of Surgery, Monash University, Melbourne, Australia.
Neurosurg Focus. 2011 Feb;30(2):E1. doi: 10.3171/2010.11.focus10244.
The prognosis for patients with hypothalamic hamartoma has improved dramatically over the last 20 years, for 3 main reasons. First, because of improved understanding of the anatomy and pathophysiology of these varied lesions.Second, due to advances in brain imaging and refinements in microsurgery, including the anterior transcallosal interforniceal approach, endoscopic, and skull-base approaches. And third, because of increasing experience with stereotactic radiosurgery, interstitial radiotherapy, and radiofrequency lesioning. Patients with hypothalamic hamartoma should be managed in comprehensive epilepsy centers where the treatments are individualized and concentrated in the hands of surgeons who can perform the full range of surgery, including approaches to the third ventricle. Total seizure-freedom rates of 52% to 66% have been achieved with surgery.
过去 20 年来，由于以下 3 个主要原因，下丘脑错构瘤患者的预后有了显著改善。首先，由于对这些不同病变的解剖学和病理生理学有了更深入的了解。其次，得益于脑成像技术的进步和显微手术的精细化，包括经胼胝体-中间帆腔入路、内镜入路和颅底入路。第三，由于立体定向放射外科、间质内放疗和射频损毁术的应用经验不断增加。下丘脑错构瘤患者应在综合癫痫中心进行治疗，这些中心的治疗方法是个体化的，并且集中在能够实施包括三脑室入路在内的所有手术的外科医生手中。手术治疗的总癫痫无发作率为 52%至 66%。
