Kida Yoshihisa
Neurological Surgery, Ookuma Hospital, Nagoya, JPN.
Cureus. 2019 Dec 31;11(12):e6523. doi: 10.7759/cureus.6523.
It is well known that cavernous malformations become much more hemorrhagic after the initial hemorrhage and that brainstem lesions are more dangerous than the lesions in the supratentorial location. It is very difficult to handle symptomatic cavernous malformations associated with repetitive hemorrhages in the brainstem. Patients may be suffering from brainstem syndromes such as hemiparesis, hemisensory disturbance, ataxia, and disturbed ocular movement. We have encountered two such difficult cases, one is very large and the other is multiple and familiar, accompanying repetitive brainstem hemorrhages. Since microsurgery seems to be very difficult and hazardous, these two cases were treated with radiosurgery after several hemorrhages.
众所周知，海绵状血管畸形在首次出血后出血的可能性会大大增加，并且脑干病变比幕上部位的病变更危险。处理与脑干反复出血相关的有症状海绵状血管畸形非常困难。患者可能会出现脑干综合征，如偏瘫、偏身感觉障碍、共济失调和眼球运动障碍。我们遇到了两例这样的疑难病例，一例体积非常大，另一例为多发且常见，伴有反复的脑干出血。由于显微手术似乎非常困难且危险，这两例病例在多次出血后接受了放射外科治疗。
