Nakaguchi Hiroshi, Hoya Katsumi, Yamada Shoko, Murakami Mineko, Matsuno Akira, Yamazaki Kazuto, Ishida Yasuo
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara, Japan.
Neurol Med Chir (Tokyo). 2011;51(5):371-5. doi: 10.2176/nmc.51.371.
A 54-year-old man presented with a rare case of cavernous angioma located in the ventral vermis manifesting as sudden onset of vertigo, followed by cerebellar ataxia. T(1)-weighted magnetic resonance imaging revealed a 1.5-cm homogeneously enhanced lesion in the ventral vermis. The postpyramidal fissure was opened widely, and upward exploration through the incision enabled piecemeal removal of the lesion without deterioration of the symptoms. The histological diagnosis was cavernous hemangioma with ruptured enlarged varices. The trans-postpyramidal fissure approach allows visualization of the entire fourth ventricle and avoids damaging the cerebellar nuclei and major postoperative cerebellar dysfunction.
一名54岁男性，患有罕见的位于小脑蚓腹侧的海绵状血管瘤，表现为突然发作的眩晕，随后出现小脑共济失调。T1加权磁共振成像显示小脑蚓腹侧有一个1.5厘米的均匀强化病灶。打开锥后裂，通过切口向上探查能够分块切除病灶，且症状未恶化。组织学诊断为伴有破裂扩张静脉曲张的海绵状血管瘤。经锥后裂入路可显露整个第四脑室，避免损伤小脑核团及术后出现严重的小脑功能障碍。
