Ramdurg Shashank R, Maitra Jaybrata
Department of Neurosurgery, MR Medical College, Gulbarga, Karnataka, India.
J Pediatr Neurosci. 2016 Jul-Sep;11(3):249-251. doi: 10.4103/1817-1745.193366.
Incidence of gliomas presenting with hemorrhage is around 3.7-7.2%. Low-grade gliomas account for <1% tumor with hemorrhage. Infants presenting with cerebellar pilocytic astrocytomas (PAs) and hemorrhage with thrombocytopenia have not been reported. We report an interesting case of a 9-month-old infant who presented to the emergency department in a drowsy state with recurrent vomiting. Laboratory investigations showed anemia, thrombocytopenia, and coagulopathy. Radiological evaluation showed a large PA with bleed. The patient was treated with retromastoid suboccipital craniotomy and tumor excision and improved postoperatively. Cerebellar PA with bleed and coagulopathy in infants has not been reported in literature till date. Their presentation seems to be acute in nature, and high index of suspicion is required for the diagnosis of these posterior fossa tumors, which can deteriorate rapidly in infants.
伴有出血的胶质瘤发病率约为3.7%-7.2%。低级别胶质瘤伴出血的肿瘤占比<1%。未曾有过婴儿患小脑毛细胞型星形细胞瘤（PA）并伴有出血及血小板减少的报道。我们报告了一例有趣的病例，一名9个月大的婴儿因反复呕吐，呈嗜睡状态被送往急诊科。实验室检查显示贫血、血小板减少和凝血病。影像学评估显示一个伴有出血的大PA。该患者接受了乳突后枕下开颅肿瘤切除术，术后病情好转。迄今为止，文献中尚未报道过婴儿小脑PA伴出血和凝血病的情况。其表现似乎具有急性性质，对于这些后颅窝肿瘤的诊断需要高度怀疑指数，因为在婴儿中病情可能迅速恶化。
