Pelissou-Guyotat I, Guyotat J, Szapiro J, Ravon R, Moreau J J, Vidal J
Service de Neurochirurgie, C.H.U. Dupuytren, Limoges.
Neurochirurgie. 1989;35(4):236-41.
Four patients were referred during the last year for treatment of an intradural metastasis. Primary sites were a bronchogenic carcinoma (one case), a prostatic carcinoma (one case) and in the two other cases the primary tumor was not found. In all cases Noot pain had lasted 1 to 5 months, despite CT examination during this painful period. Except in case n.4, diagnosis was not established until the onset of myelopathy. Surgical removal was complete in one case and subtotal in the three other cases, with complete postoperative relief of the pain in all cases and significative improvement of neurological status. The authors emphasize the importance of root pain as an early sign in these patients as well as the difficulty in establishing diagnosis. They discuss the different pathogenic mechanisms and the methods of treatment.
去年有4例患者因硬脊膜内转移瘤前来接受治疗。原发部位分别为支气管源性癌(1例)、前列腺癌(1例),另外2例未发现原发肿瘤。所有病例中,神经根性疼痛均持续了1至5个月,尽管在此疼痛期间进行了CT检查。除病例4外,直到脊髓病发作才确诊。1例手术切除完全,另外3例次全切除,所有病例术后疼痛均完全缓解,神经状态有显著改善。作者强调了神经根性疼痛作为这些患者早期体征的重要性以及诊断的困难。他们讨论了不同的致病机制和治疗方法。