Lebedev A N, Amirkhanian S E
Zh Vopr Neirokhir Im N N Burdenko. 1978 Jul-Aug(4):43-9.
The article analyses the findings of clinical and X-ray examination in 39 patients in two types of growth of neurinoma of the gasserian ganglion: with localization within the boundaries of the middle cranial fossa (22) and with the formation of tumor nodes in the middle and posterior cranial fossae (17). The first symptoms of the disease were paresthesia or numbness and continuous pain mostly in the zone innervated by the 1st--2nd pair of the trigeminal nerve, absence of corneal reflexes, high lumbar cerebrospinal fluid pressure, and protein-cellular dissociation in the cerebrospinal fluid. The craniograms revealed destruction of the floor of the middle cranial fossa with involvement of the walls of the f. ovale, spinosum et lacerum and the apex of the pyramid of the temporal bone. Carotid angiography demonstrated typical displacement of the carotid siphon to the midline, to the front, or to the back. The middle cerebral artery was moderately displaced upward and an arched art. chorioidea, anterior was noted. Growth of the neurinoma into the posterior cranial fossa was attended with displacement and deformity of a. basilaris et cerebellaris superior and the veins of the posterior cranial fossa. The ventriculograms showed compression of the inferior horn of the lateral ventricle and moderate compression of the caudal parts of the fourth ventricle and aqueduct of Sylvius. Comprehensive generalization of all the findings gained from examination of the patient is necessary in determining the topics and type of the growth of a neurinoma of the gasserian ganglion.
本文分析了39例三叉神经节神经瘤两种生长类型的临床及X线检查结果:位于中颅窝范围内(22例)以及在中颅窝和后颅窝形成肿瘤结节(17例)。该病的首发症状多为感觉异常或麻木以及持续性疼痛,主要在三叉神经第1 - 2支支配区域,角膜反射消失,腰穿脑脊液压力升高,脑脊液蛋白细胞分离。颅骨X线片显示中颅窝底部破坏,累及卵圆孔、棘孔及破裂孔壁和颞骨岩尖。颈动脉造影显示颈内动脉虹吸段典型地向中线、向前或向后移位。大脑中动脉轻度向上移位,可见弓形脉络膜前动脉。神经瘤向后颅窝生长时,基底动脉及小脑上动脉和后颅窝静脉移位及变形。脑室造影显示侧脑室下角受压,第四脑室尾部及中脑导水管中度受压。在确定三叉神经节神经瘤的生长部位和类型时,有必要对患者检查所获的所有结果进行综合归纳。