Kushel' Yu V, Belova Yu D, Tekoev A R
Burdenko Neurosurgical Institute, Moscow, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2017;81(4):56-60. doi: 10.17116/neiro201781456-60.
The article addresses the problem of intramedullary tumors (IMTs) combined with hydrocephalus (HC).
The study purpose was to explore, based on large clinical material, the occurrence of hydrocephalus combined with intramedullary tumors, possible pathogenetic mechanisms of its development, effect of tumor resection on the course of hydrocephalus, and need and timing of shunting surgery.
We present and analyze the data of the largest individual series of patients of all age groups operated on for IMTs of the spinal cord: 541 patients; 586 operations; age from 2 months to 72 years.
Our findings confirm a potential pathogenetic relationship between IMT and HC. The overall occurrence rate of HC in IMT patients was 6.3%. In patients with benign tumors (WHO Grade 1-2; 449 patients), HC developed in 25 (5.6%) cases; in patients with malignant tumors (WHO Grade 3-4; 84 patients), HC developed in 7 (8.3%) cases. A statistically significant prevalence of cervico-medullary tumors was found in HC patients: 19 (59.4%) cases. According to our data, dissemination of the tumor process is a potential factor of HC development.
本文探讨髓内肿瘤(IMTs)合并脑积水(HC)的问题。
本研究旨在基于大量临床资料,探讨髓内肿瘤合并脑积水的发生率、其发生的可能致病机制、肿瘤切除对脑积水病程的影响以及分流手术的必要性和时机。
我们呈现并分析了所有年龄组因脊髓髓内肿瘤接受手术的最大个体系列患者的数据:541例患者;586次手术;年龄从2个月至72岁。
我们的研究结果证实了髓内肿瘤与脑积水之间存在潜在的致病关系。髓内肿瘤患者中脑积水的总体发生率为6.3%。在良性肿瘤患者(世界卫生组织1 - 2级;449例患者)中,25例(5.6%)发生了脑积水;在恶性肿瘤患者(世界卫生组织3 - 4级;84例患者)中,7例(8.3%)发生了脑积水。在脑积水患者中发现颈髓肿瘤的发生率具有统计学意义:19例(59.4%)。根据我们的数据,肿瘤扩散是脑积水发生的一个潜在因素。