Shirvani Masoud, Hajimirzabeigi Alireza
Department of Neurosurgery, Milad Hospital, Tehran, the Islamic Republic of Iran.
J Neurol Surg A Cent Eur Neurosurg. 2017 May;78(3):269-280. doi: 10.1055/s-0036-1594235. Epub 2017 Jan 9.
Intraventricular cavernomas (IVCs) are extremely infrequent and only occur in 2.8 to 10% of patients with cerebral cavernomas. We describe three IVC cases and briefly review previously documented IVC cases in PubMed. Among 136 IVC cases, the mean age of the patients was 36.5 years; the male-to-female ratio was 0.8. The most frequent location was the lateral ventricle (52.6%), and most of the clinical symptoms (74%) were related to mass effects on adjacent brain tissues. Intraventricular hemorrhage occurred in 22.9% of cases. Most of the articles concluded that complete surgical resection is the treatment of choice.The microsurgical approach is currently considered the gold standard for IVC resection. Using the neuroendoscope and neuronavigational guidance and based on the biological characteristics of the IVC, proper lesion size, and dilated ventricles, we totally resected the lesion in all three cases. Neuroendoscopy can be considered as an alternative to microsurgery of IVCs. However, we believe a larger series of cases is necessary to demonstrate when microsurgery and when neuroendoscopy should be performed for IVC resection.
脑室内海绵状血管瘤（IVC）极为罕见，仅在2.8%至10%的脑海绵状血管瘤患者中出现。我们描述了3例IVC病例，并在PubMed上简要回顾了先前记录的IVC病例。在136例IVC病例中，患者的平均年龄为36.5岁；男女比例为0.8。最常见的部位是侧脑室（52.6%），大多数临床症状（74%）与对相邻脑组织的占位效应有关。22.9%的病例发生脑室内出血。大多数文章得出结论，完整的手术切除是首选治疗方法。目前，显微手术方法被认为是IVC切除的金标准。基于IVC的生物学特性、合适的病变大小和脑室扩张情况，我们在神经内镜和神经导航引导下，对所有3例病例均完整切除了病变。神经内镜可被视为IVC显微手术的替代方法。然而，我们认为需要更多的病例系列来证明IVC切除何时应进行显微手术，何时应进行神经内镜手术。
