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[与双侧听神经瘤和大脑镰脑膜瘤相关的冯·雷克林霍增氏病家族]

[A family of von Recklinghausen's disease associated with bilateral acoustic neurinomas and falx meningiomas].

作者信息

Araki Y, Imai S, Funakoshi T, Sakai N, Yamada H, Shimokawa K

出版信息

No To Shinkei. 1984 Jul;36(7):641-8.

PMID:6435649
Abstract

A familial or inherited occurrence of von Recklinghausen's disease has been reported hitherto, some of which were associated with intracranial tumors such as gliomas, neurinomas, meningiomas or others. Authers report a family (case 1: father, case 2: son, case 3: daughter) of von Recklinghausen's disease associated with both bilateral acoustic neurinomas and falx meningioma. Case 1. A 41 year-old male was admitted to our hospital with complaints of bilateral hearing disturbance, headache and loss of visual acuity. On admission, neurological examination revealed left papilledema, right cataracta, impairment of bilateral cranial nerves V, IX, X, bilateral deafness, cerebellar ataxia, motor weakness of lower extremities and sensory disturbance of peripheral region of extremities. Twelve subcutaneous nodules were noted over the entire body and Café-au-lait spots were found slightly to be scattered over the chest and the back. Craniogram and vertebral angiography demonstrated bilateral CP angle tumors, and the diagnosis of bilateral acoustic neurinomas was made. Subtotal removal of bilateral tumors and Torkildsen's shunting were carried out. Histological diagnosis was neurinoma. Post-operative course was good. But 6 years later, he complained of gait disturbance. Computed tomography revealed falx meningioma in the frontal lobe and recurrence of bilateral acoustic neurinomas. So meningioma was totally removed. Eight months after surgery he died of aspiration pneumonia aged 47. Case 2. A 15 year-old male, son of case 1, was admitted with complaints of bilateral deafness, gait disturbance and visual disturbance. Neurological examination disclosed left papilledema, right congenital cataracta, impairment of bilateral cranial nerves V, IX, X, ataxic gait and sensory disturbance of right lower extremity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

迄今为止,已有家族性或遗传性冯·雷克林霍增氏病的病例报道,其中一些与颅内肿瘤有关,如胶质瘤、神经鞘瘤、脑膜瘤等。作者报告了一个冯·雷克林霍增氏病家族(病例1:父亲,病例2:儿子,病例3:女儿),该家族同时患有双侧听神经瘤和镰旁脑膜瘤。病例1:一名41岁男性因双侧听力障碍、头痛和视力丧失入院。入院时,神经系统检查发现左侧视乳头水肿、右侧白内障、双侧第V、IX、X颅神经损害、双侧耳聋、小脑共济失调、下肢肌力减弱和四肢周围感觉障碍。全身可见12个皮下结节,胸部和背部有散在的咖啡牛奶斑。颅骨平片和椎动脉造影显示双侧桥小脑角肿瘤,诊断为双侧听神经瘤。行双侧肿瘤次全切除及托氏分流术。组织学诊断为神经鞘瘤。术后恢复良好。但6年后,他出现步态障碍。计算机断层扫描显示额叶镰旁脑膜瘤及双侧听神经瘤复发。于是将脑膜瘤全切。术后8个月,他因吸入性肺炎去世,享年47岁。病例2:病例1的15岁儿子,因双侧耳聋、步态障碍和视力障碍入院。神经系统检查发现左侧视乳头水肿、右侧先天性白内障、双侧第V、IX、X颅神经损害、共济失调步态及右下肢感觉障碍。(摘要截于250字)

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