Department of Neurosurgery, University of Washington School of Medicine, Seattle, Washington, USA.
World Neurosurg. 2013 May-Jun;79(5-6):691-703. doi: 10.1016/j.wneu.2012.04.030. Epub 2012 Sep 24.
The purpose of this study is to provide an institutional retrospective review of surgically treated brainstem cavernous malformations.
Between 2005 and 2010, 22 consecutive patients with brainstem cavernous malformations (15 female and 7 male) with a mean age of 43 years underwent surgical treatment. Mean volume of the resected cavernous malformations was 0.65 cm(3). A minimally invasive resection technique was used for these cases, in conjunction with skull base approaches.
The mean follow-up period was 26.6 months (range, 4-68 months). Of the 22 patients, 9% did not have clear evidence of hemorrhage at the time of presentation. Of the remainder, 22% had two or more instances of hemorrhage documented by magnetic resonance imaging. After resection and during follow-up, 54% of patients had an improvement in their modified Rankin scale, whereas 14% were worse compared with their preoperative presentation; 32% were unchanged and 9% of patients were found to have residual cavernoma post-surgery.
Our longitudinal experience has guided us to emphasize minimally invasive approaches during resection of the brainstem cavernous malformations, occasionally at the expense of achieving a complete resection, to improve patient outcomes.
本研究旨在对经手术治疗的脑干海绵状血管畸形进行机构回顾性分析。
2005 年至 2010 年间，22 例连续的脑干海绵状血管畸形患者（15 名女性，7 名男性）接受了手术治疗，平均年龄为 43 岁。切除的海绵状血管畸形的平均体积为 0.65cm³。这些病例采用了微创切除技术，并结合颅底入路。
平均随访时间为 26.6 个月（范围：4-68 个月）。22 例患者中，9%的患者在就诊时没有明确的出血证据。其余患者中，22%的患者有磁共振成像记录的两次或两次以上出血。切除后随访期间，54%的患者改良 Rankin 量表评分有所改善，而 14%的患者较术前更差；32%的患者无变化，9%的患者术后发现有残余海绵状血管畸形。
我们的纵向经验指导我们在切除脑干海绵状血管畸形时强调采用微创方法，偶尔以不完全切除为代价，以改善患者的预后。
