Yettou H, Marchal J C, Vinikoff L, Moret C, Czorny A, Droulé P, Chastagner P
Unité de Neurochirurgie Pédiatrique, Hôpital Saint-Julien, CHU de Nancy.
Neurochirurgie. 1994;40(4):227-32.
The authors report 11 cases of choroid plexus papillomas in children operated on from 1979 until 1993. The age ranges from 2 months to 14 years old. The most frequent location occurred in the lateral ventricles (7 cases) followed by the locations in the third ventricle (3 cases) and the fourth ventricle (1 case). A complete resection was performed in all the cases. Hydrocephalus induced by the tumors was always present. An internal and permanent shunting procedure was carried out in the pre-operative period in 5 cases, in the post-operative course in 1 case. 3 cases underwent an external CSF shunting before surgery. This external CSF drainage has been taken out a few days after the surgical resection and no further permanent internal shunting was required in the long-term outcome. In 2 cases, no CSF drainage was performed either before or after surgery. Choroid plexus papillomas (CPP) require surgical management. The hypervascularisation of these tumors can give rise to important bleeding and generate surgical difficulties particularly in children under one year. The best way to remove these tumors would be to reach the arterial feeder(s) in first place, but it is not always possible. It's also difficult to forecast wether or nor the hydrocephalus will require further permanent CSF drainage, so we have chosen to carry on an external and transient CSF shunting.
作者报告了1979年至1993年期间接受手术的11例儿童脉络丛乳头状瘤病例。年龄范围为2个月至14岁。最常见的部位是侧脑室（7例），其次是第三脑室（3例）和第四脑室（1例）。所有病例均进行了完整切除。肿瘤引起的脑积水始终存在。5例在术前进行了永久性内分流手术，1例在术后进行。3例在手术前进行了外部脑脊液分流。这种外部脑脊液引流在手术切除后几天取出，长期随访无需进一步进行永久性内分流。2例在手术前后均未进行脑脊液引流。脉络丛乳头状瘤（CPP）需要手术治疗。这些肿瘤的血管增生可导致大量出血并产生手术困难，尤其是在1岁以下儿童中。切除这些肿瘤的最佳方法是首先找到动脉供血，但并非总是可行。也很难预测脑积水是否需要进一步永久性脑脊液引流，因此我们选择进行外部临时性脑脊液分流。
