Krauss J K, Paduch T, Mundinger F, Seeger W
Department of Neurosurgery, Albert-Ludwigs-Universität, Freiburg, Federal Republic of Germany.
Acta Neurochir (Wien). 1995;133(1-2):22-9. doi: 10.1007/BF01404943.
Intracranial neoplasms are an uncommon cause of symptomatic Parkinsonism and rest tremor. We found an incidence of 0.3% in a prospective evaluation of 907 patients with supratentorial tumours. Eight patients with Parkinsonism and rest tremor secondary to supratentorial tumours sparing the basal ganglia are reported. Neuro-imaging revealed compression and distortion of the basal ganglia by large tumours which were identified histopathologically as meningiomas in four patients and as an epidermoid, a fibrillary astrocytoma, an anaplastic oligodendroglioma and a glioblastoma. Six patients underwent tumour removal by craniotomy, in two the histopathology was obtained by stereotactic biopsy. Four patients were free of Parkinsonian symptoms and signs on long-term follow-up. The possible pathophysiological mechanisms involved are discussed. Since some of these patients closely resemble cases of idiopathic Parkinson's disease, and the movement disorder can precede other symptoms and signs or will remain isolated in the further course, the diagnosis of an intracranial neoplasm was generally delayed in these patients. Increased awareness of this rare entity may lead to an earlier diagnosis. Early computed tomography in patients with Parkinsonism might help to detect these patients with a potentially curable cause of their condition.
颅内肿瘤是症状性帕金森病和静止性震颤的罕见病因。在对907例幕上肿瘤患者的前瞻性评估中，我们发现其发病率为0.3%。本文报告了8例继发于幕上肿瘤且不累及基底节的帕金森病和静止性震颤患者。神经影像学显示大肿瘤对基底节产生压迫和变形，经组织病理学鉴定，其中4例为脑膜瘤，1例为表皮样囊肿，1例为纤维型星形细胞瘤，1例为间变性少突胶质细胞瘤，1例为胶质母细胞瘤。6例患者接受了开颅肿瘤切除术，2例通过立体定向活检获得组织病理学结果。4例患者在长期随访中无帕金森病症状和体征。文中讨论了可能涉及的病理生理机制。由于其中一些患者与特发性帕金森病病例极为相似，且运动障碍可能先于其他症状和体征出现，或者在后续病程中保持孤立状态，因此这些患者颅内肿瘤的诊断通常延迟。提高对这种罕见疾病的认识可能会导致更早的诊断。对帕金森病患者早期进行计算机断层扫描可能有助于发现这些病因潜在可治愈的患者。
