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[蝶骨平台脑膜瘤所致症状性颈动脉狭窄的术前血管内治疗]

[Presurgical endovascular treatment of symptomatic carotid stenosis caused by a meningioma of the planum sphenoidale].

作者信息

Fernandez-Valverde F, Jimenez-Gomez E, Roldan-Romero E, Bravo-Rodriguez F

机构信息

Sección de Neurorradiología Diagnóstica y Terapéutica, UCG de Radiodiagnóstico, Hospital Universitario Reina Sofía, Córdoba, España.

出版信息

Rev Neurol. 2013 Feb 1;56(3):157-60.

Abstract

INTRODUCTION

Cerebral infarction is a very rare presenting symptom of a meningioma. This form of clinical onset poses the challenge of treating ischaemic events before dealing with the tumour surgically.

CASE REPORT

A 48-year-old woman from Georgia who visited due to loss of strength in the right-hand side of the body, intense headache and self-limiting episodes of forgetting her own language. Computerised axial tomography scans of her head revealed a left frontal expansive process and hypodense lesions in the left caudate nucleus. The patient underwent an unfavourable progression, with episodes of neurological deterioration and hemiparesis of the right-hand side and aphasia, which alternated with periods of improvement. Magnetic resonance imaging and an angiographic study revealed tumour occlusion of the left middle cerebral artery, secondary to a clinoidal meningioma. Treatment involved endovascular recanalisation of the middle cerebral artery and later surgical removal of the meningioma.

CONCLUSIONS

Endovascular treatment by means of angioplasty, prior to the surgical excision of the tumour, is a technique that enables the incidence of ischaemic events to be diminished.

摘要

引言

脑梗死是脑膜瘤非常罕见的一种表现症状。这种临床发病形式给在手术治疗肿瘤之前处理缺血性事件带来了挑战。

病例报告

一名来自格鲁吉亚的48岁女性,因身体右侧无力、剧烈头痛以及出现自限性的语言遗忘发作前来就诊。其头部计算机断层扫描显示左侧额叶有占位性病变,左侧尾状核有低密度病灶。患者病情进展不利,出现神经功能恶化发作、右侧偏瘫和失语,病情呈交替性改善。磁共振成像和血管造影研究显示,继发于床突脑膜瘤的左侧大脑中动脉肿瘤性闭塞。治疗包括大脑中动脉的血管内再通,随后手术切除脑膜瘤。

结论

在肿瘤手术切除之前通过血管成形术进行血管内治疗是一种能够降低缺血性事件发生率的技术。

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