Choque-Velasquez Joham, Resendiz-Nieves Julio, Colasanti Roberto, Collan Juhani, Hernesniemi Juha
Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Centro de Investigación en Anatomía y Fisiologia Alto Andina, Universidad Andina del Cusco, Cusco, Peru.
Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
World Neurosurg. 2018 Sep;117:e669-e678. doi: 10.1016/j.wneu.2018.06.110. Epub 2018 Jun 23.
Vascular pineal malformations are rare and technically demanding lesions. Because the locations of these lesions, endovascular techniques and radiosurgery have been increasingly used in the recent decades to accomplish safe occlusion. Nevertheless, microsurgical treatment may be required sometimes.
We present a retrospective review of the vascular pineal malformations operated by the senior author. Moreover, we report illustrative cases for the various types of vascular lesions with a careful analysis of the different microsurgical stages.
Eighteen patients with pineal vascular lesions were operated on between 1980 and 2015: 6 patients had vein of Galen malformations, 5 plexiform arteriovenous malformations, 6 cavernous malformations, and 1 patient had a ruptured medial posterior choroidal artery aneurysm. A complete resection and occlusion was possible in all vascular malformations.
The pineal region is an infrequent but challenging location for vascular lesions. A careful and stepwise operative strategy for the different types of vascular lesion is paramount to accomplish an effective and safe microsurgical treatment when other alternatives fail or are not available.
血管性松果体畸形罕见且技术要求高。由于这些病变的位置，近几十年来血管内技术和放射外科已越来越多地用于实现安全闭塞。然而，有时可能仍需要显微外科治疗。
我们对资深作者手术治疗的血管性松果体畸形进行了回顾性研究。此外，我们报告了各种类型血管病变的典型病例，并对不同的显微外科手术阶段进行了仔细分析。
1980年至2015年间，18例松果体血管病变患者接受了手术：6例患有大脑大静脉畸形，5例为丛状动静脉畸形，6例为海绵状畸形，1例患者患有脉络膜后内侧动脉破裂性动脉瘤。所有血管畸形均实现了完全切除和闭塞。
松果体区是血管病变的少见但具有挑战性的部位。当其他治疗方法失败或不可用时，针对不同类型血管病变采取谨慎且循序渐进的手术策略对于实现有效且安全的显微外科治疗至关重要。
