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[侧脑室肿瘤。284例病例回顾]

[Tumors of the lateral ventricle. Review of 284 cases].

作者信息

Baroncini M, Peltier J, Le Gars D, Lejeune J-P

机构信息

Pôle des neurosciences et de l'appareil locomoteur, clinique de neurochirurgie, hôpital Salengro, CHRU de Lille, rue du Pr E.-Laine, 59037 Lille cedex, France.

出版信息

Neurochirurgie. 2011 Sep-Dec;57(4-6):170-9. doi: 10.1016/j.neuchi.2011.09.020. Epub 2011 Oct 26.

Abstract

UNLABELLED

The data from 284 cases of lateral ventricle (VL) tumors treated in 18 departments of Neurosurgery in France between 1995 and 2010 were collected in this series. The mean age was 33 years with a large proportion of children (79/284).

CLINICAL PRESENTATION

The mean duration of symptoms was short in time (2 months). The revelation was incidental in 10% of the cases; for symptomatic lesions, raised intracranial pressure (ICP, due to hydrocephalus) and neuropsychological signs were the most frequent. Only one third of the patients had no CSF disorder.

HISTOPATHOLOGY

The two most frequent tumors were meningiomas (40 cases, 15%) and neurocytomas (35 cases, 13%). The sub-ependymal giant cells astrocytomas, the ependymomas and sub-ependymomas were also common (11, 10 and 9% respectively).

THERAPEUTIC MANAGEMENT

A surgical procedure was performed in 258 patients, with the help of neuronavigation in one third of cases. The patients were most frequently operated with a transfrontal approach (40%). The resection was complete in 73%, which was a statistical factor of global survival. The postoperative mortality rate was 4.9%.

OUTCOME

Neuropsychological deficits were the most frequent sequelae (22.8%) due to raised ICP. Campimetric deficits (19%), seizures (19%), hemiparesis (15%) and language disorders (12%) were then found. The mean follow-up was 52 months with good evolution for 58% of patients. Fifteen percent of patients had a handicap and, finally, 12.9% will die. At last, two third of living patients had no tumoral residue or re-evolution.

摘要

未标注

本系列收集了1995年至2010年间法国18个神经外科科室治疗的284例侧脑室(VL)肿瘤的数据。平均年龄为33岁,儿童占很大比例(79/284)。

临床表现

症状的平均持续时间较短(2个月)。10%的病例为偶然发现;对于有症状的病变,颅内压升高(由于脑积水导致的ICP)和神经心理学体征最为常见。只有三分之一的患者没有脑脊液紊乱。

组织病理学

最常见的两种肿瘤是脑膜瘤(40例,15%)和神经细胞瘤(35例,13%)。室管膜下巨细胞星形细胞瘤、室管膜瘤和室管膜下瘤也很常见(分别为11%、10%和9%)。

治疗管理

258例患者接受了手术,三分之一的病例借助神经导航进行。患者最常采用经额叶入路手术(40%)。73%的切除是完整的,这是总体生存的一个统计学因素。术后死亡率为4.9%。

结果

由于颅内压升高,神经心理学缺陷是最常见的后遗症(22.8%)。然后发现了视野缺损(19%)、癫痫发作(19%)、偏瘫(15%)和语言障碍(12%)。平均随访时间为52个月,58%的患者病情进展良好。15%的患者有残疾,最后,12.9%的患者将死亡。最后,三分之二的存活患者没有肿瘤残留或复发。

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