Jelsma R K, Jelsma L F, Johnson G S
Audubon Hospital, Louisville, Kentucky.
Surg Neurol. 1993 Jun;39(6):494-510. doi: 10.1016/0090-3019(93)90037-2.
The surgical removal of a brainstem astrocytoma or hemangioblastoma entails the risk of a major neurological injury, but if injury can be avoided, the benefits of surgery are considerable in some types of these tumors. Most brainstem astrocytomas are widely infiltrative diffuse tumors that frequency undergo malignant change and are not benefitted by surgery. However, dorsally exophytic brainstem astrocytomas, focal cervicomedullary astrocytomas, and focal brainstem astrocytomas have a more benign character and frequently are benefitted by surgical removal or other surgical intervention. Brainstem hemangioblastomas may be extramedullary tumors or cystic intramedullary tumors, and surgical removal of these tumors is usually possible and is the optimal treatment. Three cases are presented to illustrate that excellent results can be obtained by surgical resection of certain types of brainstem astrocytoma or hemangioblastoma. The clinical and radiographic characteristics and the results of surgical treatment for each of these types of brainstem tumor are discussed.
手术切除脑干星形细胞瘤或血管母细胞瘤存在重大神经损伤风险，但如果能够避免损伤，对于某些类型的这类肿瘤，手术益处显著。大多数脑干星形细胞瘤是广泛浸润性弥漫性肿瘤，常发生恶变，手术对其并无益处。然而，背侧外生性脑干星形细胞瘤、局灶性颈髓星形细胞瘤和局灶性脑干星形细胞瘤具有更良性的特征，手术切除或其他手术干预通常对其有益。脑干血管母细胞瘤可能是髓外肿瘤或囊性髓内肿瘤，通常可以进行手术切除，这是最佳治疗方法。本文介绍三例病例，以说明手术切除某些类型的脑干星形细胞瘤或血管母细胞瘤可取得优异效果。文中还讨论了这些类型脑干肿瘤各自的临床和影像学特征以及手术治疗结果。
