Kosteljanetz M, Albrecht-Beste E, Laursen H
Neurokirurgisk afdeling, Rigshospitalet, København.
Ugeskr Laeger. 1993 Dec 20;155(51):4177-80.
Between July 1988 and July 1990, 42 patients with low-grade gliomas of the cerebrum were treated in our department. Their age ranged from six to 72, there were 27 males and 15 females. Seventy-nine percent of the patients had suffered from epileptic fits, in 69% it was the presenting symptom. Thirty-one percent had normal neurological examination. On CT-scanning most tumours were hypodense, one-third demonstrated enhancement after intravenous contrast. Midline shift suggested a grade two tumour, but otherwise it was not possible to distinguish between grade one and grade two tumours on CT or MR. There was an unaccountable overweight of tumours on the left side of the brain. Forty patients underwent surgery, in one-third a radical extirpation was undertaken. In six patients a biopsy was nondiagnostic. Twenty-five percent had postoperative radiation. Adult patients who suffer an epileptic seizure without any other obvious aetiology should have a CT or MR scan even in cases when the neurological examination is normal.
1988年7月至1990年7月期间,我科收治了42例大脑低级别胶质瘤患者。他们的年龄在6岁至72岁之间,男性27例,女性15例。79%的患者有癫痫发作,其中69%以此为首发症状。31%的患者神经系统检查正常。CT扫描显示大多数肿瘤为低密度,三分之一的肿瘤静脉注射造影剂后有强化。中线移位提示为二级肿瘤,但在CT或磁共振成像(MR)上无法区分一级和二级肿瘤。大脑左侧肿瘤数量过多,原因不明。40例患者接受了手术,其中三分之一进行了根治性切除。6例患者活检未能明确诊断。25%的患者术后接受了放疗。即使神经系统检查正常,无其他明显病因却出现癫痫发作的成年患者也应进行CT或MR扫描。