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Reversible Bilateral Transverse Sinus Occlusion Treated by Lumboperitoneal Shunt in Idiopathic Intracranial Hypertension: A Case Report. 通过腰腹腔分流术治疗特发性颅内高压的可逆性双侧横窦闭塞:病例报告。
Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0140
Atsuhito Taishaku, Takayuki Ohno, Takashi Iwata, Hiromi Shibata, Motoki Ishida, Noritaka Aihara

We report a patient with idiopathic intracranial hypertension (IIH) with bilateral transverse sinus occlusion treated by a lumboperitoneal shunt. A 45-year-old woman presented with visual disturbance and chronic headache. Magnetic resonance (MR) venography and three-dimensional computed tomography angiography (3D-CTA) showed occlusion of both transverse sinuses. After the surgery, MR venography and 3D-CTA showed no blockages in both transverse sinuses. This phenomenon reveals that obstruction of the bilateral transverse sinus is a consequence of intracranial hypertension, not just a single cause. Since many patients have an obstruction or stenosis of the venous sinus, there are some reports of endovascular treatment. Sinus reconstruction is usually effective, but it is not effective in some cases. Reversal of sinus occlusion suggests that endovascular therapy for IIH is inadequate in some cases.

我们报告了一名特发性颅内高压(IIH)伴双侧横窦闭塞的患者,该患者接受了腰腹腔分流术治疗。患者是一名 45 岁女性,出现视力障碍和慢性头痛。磁共振(MR)静脉造影和三维计算机断层扫描(3D-CTA)显示双侧横窦闭塞。手术后,磁共振静脉造影和三维计算机断层扫描显示两个横窦均无阻塞。这一现象表明,双侧横窦阻塞是颅内高压的结果,而不仅仅是单一原因。由于许多患者的静脉窦阻塞或狭窄,因此有一些关于血管内治疗的报道。静脉窦重建通常有效,但在某些病例中效果不佳。静脉窦闭塞的逆转表明,血管内治疗 IIH 在某些病例中并不充分。
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引用次数: 0
Early Response to Radiation Therapy without Surgical Intervention in a Giant Cavernous Sinus Hemangioma with Hydrocephalus: A Case Report. 巨大海绵窦血管瘤伴脑积水患者对放射治疗的早期反应而无需手术干预:病例报告。
Pub Date : 2023-11-29 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0094
Noriyuki Watanabe, Masashi Mizumoto, Taishi Amano, Hisayuki Hosoo, Akinari Yamano, Alexander Zaboronok, Masahide Matsuda, Shingo Takano, Yuji Matsumaru, Eiichi Ishikawa

Cavernous sinus hemangioma (CSH) is a rare vascular malformation, arising from the cavernous sinus. Because of its anatomically complex location, a large lesion can cause a variety of symptoms due to cranial nerve compression. A 69-year-old woman with an unsteady gait was admitted to our hospital, and magnetic resonance imaging revealed an extra-axial giant tumor in the cavernous sinus and enlarged ventricles. A radiographic diagnosis of CSH was made. As the risk of surgical removal was considered high, the patient underwent intensity-modulated radiation therapy of 50.4 Gy in 28 fractions. The size of the tumor decreased markedly over time, and the symptoms improved soon after treatment. A 61.8% reduction in tumor size was confirmed immediately after irradiation, and a 75.9% reduction was revealed at a follow-up visit one year later. We reported a case of a giant CSH with hydrocephalus, where tumor shrinkage was confirmed immediately after radiation therapy, and the symptoms of hydrocephalus improved without surgical intervention.

海绵窦血管瘤(CSH)是一种罕见的血管畸形,源于海绵窦。由于其解剖位置复杂,巨大的病变可因压迫颅神经而引起各种症状。我院收治了一名步态不稳的 69 岁女性,磁共振成像显示她的海绵窦内有一个轴外巨大肿瘤,脑室增大。影像学诊断为 CSH。由于手术切除的风险较高,患者接受了强度调控放射治疗,治疗剂量为 50.4 Gy,分 28 次进行。随着时间的推移,肿瘤体积明显缩小,治疗后症状很快得到改善。照射后立即证实肿瘤缩小了 61.8%,一年后的随访显示肿瘤缩小了 75.9%。我们报告了一例伴有脑积水的巨大 CSH 病例,放疗后立即证实肿瘤缩小,脑积水症状改善,无需手术干预。
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引用次数: 0
Patient with Diffuse Midline Glioma, H3 K27-altered, Carrying an FGFR1 Mutation Who Experienced Thalamic Hemorrhage: A Case Report and Literature Review. 弥漫中线胶质瘤患者,H3 K27 变异,携带 FGFR1 基因突变,丘脑出血:病例报告与文献综述
Pub Date : 2023-11-11 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0035
Kyosuke Matsunaga, Shinjiro Fukami, Nobuyuki Nakajima, Norio Ichimasu, Michihiro Kohno

Diffuse midline glioma (DMG), H3 K27M-altered, is a tumor with a poor prognosis mainly found in children. An adolescent patient presented with thalamic hemorrhage, which initially could not be diagnosed as DMG by pathological analysis. A neoplasm in the lateral ventricle close to the previous thalamic hemorrhagic lesion was detected 12 months after the hemorrhage. Thus, endoscopic resection was performed, and a diagnosis was made. Gene expression profiling demonstrated mutation in genes, such as H3F3A and FGFR1. FGFR1 mutation was associated with intratumoral hemorrhage in low-grade gliomas and contributed to longer survival than wild-type FGFR1 in DMG H3K27M. Our findings suggest that patients with DMG, H3 K27-altered, with FGFR1 mutation may be predisposed to intratumoral hemorrhaging and/or have a longer survival time than patients without FGFR1 mutation.

弥漫中线胶质瘤(DMG),H3 K27M改变,是一种预后不良的肿瘤,主要见于儿童。一名青少年患者因丘脑出血而就诊,病理分析最初无法将其诊断为 DMG。出血 12 个月后,在靠近之前丘脑出血病灶的侧脑室发现了肿瘤。因此,对其进行了内窥镜切除术,并做出了诊断。基因表达谱分析显示,H3F3A 和 FGFR1 等基因发生了突变。FGFR1突变与低级别胶质瘤的瘤内出血有关,与野生型FGFR1相比,DMG H3K27M患者的生存期更长。我们的研究结果表明,与未发生FGFR1突变的患者相比,H3 K27改变的DMG患者如果发生FGFR1突变,可能容易发生瘤内出血和/或存活时间更长。
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引用次数: 0
Malignant Transformation and Leptomeningeal Melanomatosis in a Primary Meningeal Melanocytoma: A Case Report and Review of Literature. 原发性脑膜黑色素细胞瘤的恶性转化和脑膜黑色素瘤病:病例报告和文献综述。
Pub Date : 2023-11-11 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0109
Kenta Nakase, Ryosuke Matsuda, Tomoya Okamoto, Ichiro Nakagawa, Maiko Takeda, Katsumi Sakata, Hiroyuki Nakase

Meningeal melanocytomas of the central nervous system, although typically benign, rarely undergo malignant transformations. A 46-year-old man presented with headache and nausea 4 years after gross total resection of a craniovertebral junction meningeal melanocytoma at another hospital. The initial clinical course was previously reported.1) Computed tomography revealed the presence of multiple intracranial mass lesions. Furthermore, magnetic resonance imaging showed multiple intracranial lesions and meningeal dissemination. A biopsy was performed for a circumflex lesion located in the right frontal lobe. Pathological examination showed anaplastic changes and a Ki-67 index of 33%. Based on the pleomorphic changes and high mitotic activity, the patient was diagnosed with primary cerebral malignant melanoma. The patient received four cycles of nivolumab (80 mg) and ipilimumab (165 mg), followed by whole-brain radiotherapy (37.5 Gy). However, the disease progressed after the third cycle. Genome analysis revealed GNAQ Q209P and SF3B1 R625C mutations, but no treatments related to these gene mutations were available. Despite the seven cycles of nivolumab therapy, the patient eventually passed away 9 months after surgery. This case was a rare example of malignant transformation and leptomeningeal melanomatosis in a meningeal melanocytoma. It highlights the importance of careful follow up after gross total resection. Identification of molecular alterations can lead to better detection of melanocytic melanomas with poor prognosis and high risk of recurrence and metastasis. It can also facilitate the development of novel therapeutic options for these patients.

中枢神经系统的脑膜黑色素细胞瘤虽然通常是良性的,但很少发生恶变。一名 46 岁男子在另一家医院接受了颅椎交界处脑膜黑色素细胞瘤的全切手术,术后 4 年出现头痛和恶心症状。1)计算机断层扫描显示存在多个颅内肿块病变。此外,磁共振成像显示存在多个颅内病变和脑膜播散。对位于右额叶的环状病灶进行了活检。病理检查显示为无弹性改变,Ki-67指数为33%。根据多形性改变和高有丝分裂活性,患者被诊断为原发性脑恶性黑色素瘤。患者接受了四个周期的 nivolumab(80 毫克)和 ipilimumab(165 毫克)治疗,随后接受了全脑放疗(37.5 Gy)。然而,第三个周期后病情出现进展。基因组分析发现了GNAQ Q209P和SF3B1 R625C基因突变,但没有与这些基因突变相关的治疗方法。尽管患者接受了 7 个周期的 nivolumab 治疗,但最终还是在术后 9 个月去世。该病例是脑膜黑色素细胞瘤恶性转化和脑膜黑色素瘤病变的罕见病例。它强调了在大体全切除术后进行仔细随访的重要性。分子改变的鉴定可以更好地发现预后不良、复发和转移风险高的黑色素细胞瘤。这也有助于为这些患者开发新的治疗方案。
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引用次数: 0
Epilepsy with Eyelid Myoclonia Complicated by Polycystic Ovary Syndrome: Valproate Withdrawal, Vagus Nerve Stimulation, and Seizure Reduction. 多囊卵巢综合征并发眼睑肌张力障碍性癫痫:丙戊酸钠戒断、迷走神经刺激和减少癫痫发作。
Pub Date : 2023-11-11 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0083
Kyoko Tatebayashi, Ichiro Takumi, Takashi Matsumori, Kimiyuki Kawaguchi, Hidetoshi Murata

Epilepsy with eyelid myoclonia is a childhood-onset generalized epilepsy, which is more common in women. Over 90% of the patients continue antiseizure medications, especially valproate, and more than 60% of cases are refractory. The efficacy of vagus nerve stimulation in treating eyelid myoclonia is still unknown. Polycystic ovary syndrome is highly prevalent in women with epilepsy receiving valproate; nevertheless, no reports on the complication of polycystic ovary syndrome in women with epilepsy with eyelid myoclonia were found. In this report, a case of a woman with epilepsy with eyelid myoclonia who developed polycystic ovary syndrome while receiving valproate and underwent vagus nerve stimulation is described. A 26-year-old female patient has been administered valproate since the occurrence of generalized seizures at the age of 12 years and then developed polycystic ovary syndrome. When the dose of valproate was reduced as an adult, her epilepsy became intractable. Information from her mother led to a video electroencephalography re-evaluation, and she was finally diagnosed 15 years after onset. The patient underwent vagus nerve stimulation. In a short-term follow-up, she achieved >50% seizure reduction at low output currents of <1.00 mA. Polycystic ovary syndrome was cured 15 months after valproate withdrawal. There are three key points presented in this case: Vagus nerve stimulation therapy was useful for treating epilepsy with eyelid myoclonia with absence. Women with epilepsy with eyelid myoclonia taking valproate must be aware of the risk of polycystic ovary syndrome and monitor their menstrual cycles. Information from the family, such as home videos, helped with the diagnosis.

眼睑肌张力癫痫是一种儿童期发病的全身性癫痫,女性患者更常见。90% 以上的患者需要继续服用抗癫痫药物,尤其是丙戊酸钠,60% 以上的病例为难治性。迷走神经刺激治疗眼睑肌张力障碍的疗效尚不清楚。多囊卵巢综合征在接受丙戊酸钠治疗的女性癫痫患者中发病率很高,但目前还没有关于眼睑肌张力障碍女性癫痫患者并发多囊卵巢综合征的报道。本报告描述了一例患有眼睑肌张力障碍的女性癫痫患者在服用丙戊酸钠期间出现多囊卵巢综合征并接受迷走神经刺激治疗的病例。一名 26 岁的女性患者自 12 岁出现全身性癫痫发作以来一直服用丙戊酸钠,后来患上了多囊卵巢综合征。成年后丙戊酸钠剂量减少,她的癫痫变得难以治愈。她母亲提供的信息促使她接受了视频脑电图再评估,最终在发病 15 年后被确诊。患者接受了迷走神经刺激术。在短期随访中,她在低输出电流为
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引用次数: 0
Alternative Proximal Protection Method during Carotid Artery Stenting Using Combined Transbrachial and Transradial Artery Approaches. 经肱动脉和经桡动脉联合入路颈动脉支架置入术中另一种近端保护方法。
Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0071
Yuki Hamada, Fumio Miyashita, Hideki Matsuoka, Yuki Nishinakama, Yusuke Kai, Yusuke Yamashita, Mei Ikeda, Go Takaguchi, Keisuke Masuda, Fumikatsu Kubo, Hiroshi Takashima

Herein, we report a case of carotid artery stenting with proximal flow protection for severe stenosis of the left internal carotid artery using transbrachial and transradial artery approaches. Because an abdominal aortic aneurysm was present, we avoided the transfemoral approach. The procedure was successfully performed with a combination of an 8-Fr balloon guide catheter and microballoon catheter on separate axes. No complications such as pseudoaneurysm, thrombosis, or dissection were observed at the puncture site. The patient was discharged without complications and showed good outcomes at 3 months. This technique may offer a useful alternative for patients with severe stenosis who cannot be treated using a femoral artery approach.

在此,我们报告一例颈动脉支架置入近端血流保护,用于经肱动脉和经桡动脉入路治疗严重的左颈内动脉狭窄。由于存在腹主动脉瘤,我们避免了经股入路。该手术通过8-Fr球囊导管和微球囊导管在不同轴上的组合成功完成。穿刺部位未见假性动脉瘤、血栓形成、夹层等并发症。患者出院时无并发症,3个月后预后良好。该技术可能为不能使用股动脉入路治疗的严重狭窄患者提供有用的替代方法。
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引用次数: 0
Pilocytic Astrocytoma Presenting with Spontaneous Cerebellar Hemorrhage: A Case Report. 毛细胞星形细胞瘤并发自发性小脑出血1例。
Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0152
Sae Yamanaka, Hiroshi Tokimura, Nayuta Higa, Hirofumi Iwamoto, Yosuke Nishimuta, Kazunobu Sueyoshi, Hajime Yonezawa, Kenichiro Tajitsu, Toshiaki Akahane, Akihide Tanimoto, Ryosuke Hanaya

Hemorrhagic pilocytic astrocytomas (PAs) are rare, accounting for 1.1%-8.0% of all PA cases. They are reported to occur more frequently in older populations, with a male predominance. In this study, we report a case of a 14-year-old boy who presented with a headache, vertigo, and diplopia. As per his brain computed tomography scan, a small hematoma was observed in the left inferior cerebellar peduncle. Follow-up magnetic resonance imaging (MRI) revealed repeated minor bleeding from the lesion and mild expansion, with no neurological deficits. Four years later, the patient developed nausea, vomiting, and left abducens palsy. MRI revealed a mulberry-shaped mass surrounded by a hypointense rim, suggesting a cavernous angioma. The lesion was surgically resected via midline occipital craniotomy with the opening of the cerebellomedullary fissure. Histopathological examination of the lesion revealed PA. Next-generation sequencing analyses revealed that PAs harbored mutations in the ARID1A, ATM, and POLE genes but not in the BRAF gene. To the best of our knowledge, there are yet no reported studies on these mutations in PAs to date. Thus, PA should be considered in the differential diagnosis of cerebellar hemorrhage, especially in young adults and children..

出血性毛细胞星形细胞瘤(PAs)罕见,占所有PA病例的1.1%-8.0%。据报道,它们更常发生在老年人群中,以男性为主。在这项研究中,我们报告了一个14岁的男孩,他表现出头痛、眩晕和复视。根据他的脑部计算机断层扫描,在左小脑下脚观察到一个小血肿。后续磁共振成像(MRI)显示病变反复轻微出血和轻度扩张,无神经功能障碍。四年后,患者出现恶心、呕吐和左外展肌麻痹。MRI示桑葚状肿块,周围有低信号边缘,提示海绵状血管瘤。病变通过开放小脑髓裂的枕中线开颅手术切除。病变组织病理学检查显示PA。下一代测序分析显示,PAs在ARID1A、ATM和POLE基因中存在突变,但在BRAF基因中没有突变。据我们所知,迄今为止还没有关于PAs中这些突变的研究报告。因此,在小脑出血的鉴别诊断中应考虑PA,特别是在青年和儿童中。
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引用次数: 0
Systemic Metastasis of Pediatric Diffuse High-grade Astrocytoma: A Case Report. 小儿弥漫性高级星形细胞瘤的全身转移1例报告。
Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0018
Kentaro Chiba, Yasuo Aihara, Yuichi Oda, Kenta Masui, Takashi Komori, Hideaki Yokoo, Takakazu Kawamata

Extracranial brain tumor metastases are extremely rare. The etiology, pathophysiology, and clinical progression of systemic metastatic brain cancer remain to be elucidated. We encountered a case of pediatric diffuse high-grade astrocytoma in a four-year-old girl with subcutaneous and lymph node metastases. Numerous metastatic lesions emerged, progressed rapidly, and were difficult to manage despite temozolomide (TMZ) administration. The patient underwent repeated surgical resection for these lesions. Conversely, the primary intracranial lesions responded well to TMZ for some time. However, the patient died 15 months after the initial diagnosis. Extracranial metastasis and highly varying effects of chemotherapy were the characteristic clinical features in this case. Our analysis did not reveal definitive histopathological and molecular factors contributing to this presentation. The lack of notable molecular pathological features illustrates the unpredictability of glioma metastasis, and the treatment for extracranial metastasis remains unknown. A gene panel analysis revealed several genetic aberrations, including PDGFRA, PIK3CA, and NBN mutations. As it is impossible to resect all frequently and rapidly progressing lesions, we stress that the prognosis of metastatic brain tumors is undoubtedly poor if these tumors are refractory to existing treatments, including chemotherapy.

颅外脑肿瘤转移极为罕见。系统性转移性脑癌的病因、病理生理和临床进展仍有待阐明。我们遇到了一个4岁女孩的儿童弥漫性高级别星形细胞瘤,并伴有皮下和淋巴结转移。许多转移性病变出现,进展迅速,尽管使用替莫唑胺(TMZ)仍难以控制。患者接受了多次手术切除这些病变。相反,原发性颅内病变在一段时间内对TMZ反应良好。然而,患者在初步诊断后15个月死亡。颅外转移和化疗效果的高度变化是本病例的典型临床特征。我们的分析并没有明确揭示导致这种表现的组织病理学和分子因素。缺乏显著的分子病理特征说明胶质瘤转移的不可预测性,颅内外转移的治疗仍然未知。基因面板分析显示了几种遗传畸变,包括PDGFRA、PIK3CA和NBN突变。由于不可能切除所有频繁和快速进展的病变,我们强调,如果转移性脑肿瘤对现有的治疗方法(包括化疗)难以治愈,预后无疑是很差的。
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引用次数: 0
Iatrogenic Arteriovenous Fistula between the Middle Meningeal Artery and Pterygoid Venous Plexus Secondary to a Le Fort I Osteotomy: A Case Report. Le Fort I截骨术继发于脑膜中动脉与翼状静脉丛之间的医源性动静脉瘘1例。
Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0108
Yuhei Ito, Takao Kojima, Takuya Maeda, Masazumi Fujii

Le Fort I osteotomy is a common surgical technique for correcting jaw deformities. Although it is generally a safe procedure, there have been cases of postoperative vascular complications, which include arteriovenous fistulas. Published reports describe the development of arteriovenous fistulas that originate from the maxillary artery after this procedure; nevertheless, no cases of arteriovenous fistulas arising from the middle meningeal artery (MMA) have been reported. We present the case of a 19-year-old woman who developed pulsatile tinnitus immediately following a Le Fort I osteotomy. Angiography with proximal flow control of the external carotid artery showed an arteriovenous fistula between the extracranial portion of the MMA and the pterygoid venous plexus. The fistula was successfully treated using coil embolization, preserving the maxillary artery, which results in tinnitus resolution. In this report, the effectiveness of endovascular treatment for arteriovenous fistulas of the MMA that occur following a Le Fort I osteotomy was demonstrated. Angiography with proximal flow interruption was effective in shunt location detection.

Le Fort I型截骨术是矫正颌骨畸形的常用手术技术。虽然这通常是一种安全的手术,但也有术后血管并发症的病例,包括动静脉瘘。已发表的报告描述了该手术后起源于上颌动脉的动静脉瘘的发展;然而,没有一例起源于脑膜中动脉(MMA)的动静脉瘘的报道。我们提出的情况下,19岁的妇女谁发展搏动性耳鸣立即后,Le Fort I截骨。外颈动脉近端血流控制血管造影显示MMA颅外部分与翼状静脉丛之间有动静脉瘘。使用线圈栓塞术成功治疗瘘管,保留了上颌动脉,耳鸣得以消除。在本报告中,血管内治疗Le Fort I型截骨术后MMA动静脉瘘的有效性得到了证实。近端血流中断的血管造影在分流位置检测中是有效的。
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引用次数: 0
Endoscope-assisted Trans-lamina Terminalis Resection of Chordoid Glioma at the Third Ventricle: A Case Report. 内窥镜辅助经终板切除第三脑室脊索样胶质瘤1例。
Pub Date : 2023-10-14 eCollection Date: 2023-01-01 DOI: 10.2176/jns-nmc.2023-0107
Yuichi Oda, Kosaku Amano, Kentaro Chiba, Kenta Masui, Takakazu Kawamata

As per the 2021 World Health Organization (WHO) Classification of Tumors of the Central Nervous System, chordoid glioma (CG) is defined as a slow-growing glial neoplasm categorized as grade II tumor. This tumor is primarily located in the anterior part of the third ventricle, often adheres to important surrounding structures, and is hemorrhagic in nature. Therefore, dissecting this tumor is extremely difficult. In this study, we present the case of a 44-year-old man who initially complained of mild headache and was diagnosed with a homogeneous gadolinium-enhanced lesion in the third ventricle via magnetic resonance imaging. The pathological diagnosis based on his biopsy at the previous hospital was CG. The patient demonstrated no neurological deficit at that time, but the tumor had gradually grown, hydrocephalus appeared 2 years after the tumor was detected, and the patient developed short memory disorder and daytime sleepiness. We resected the tumor via the anterior interhemispheric trans-lamina terminalis approach using a microscope and an endoscope. The residual tumor at the blind spot of the microscopic view was resected under an angled rigid endoscopic view using dedicated tools for transsphenoidal surgery. The tumor was grossly resected, and the histopathological diagnosis was CG. Postoperative neurological findings included slight memory disorder and hypothalamic adrenal dysfunction. No tumor recurrence was reported 3 years post resection. The endoscope-assisted anterior interhemispheric trans-lamina terminalis approach was determined useful for CG resection with minimal surgical complications and without tumor recurrence.

根据2021年世界卫生组织(WHO)中枢神经系统肿瘤分类,脊索样胶质瘤(CG)被定义为一种生长缓慢的神经胶质肿瘤,被归类为II级肿瘤。该肿瘤主要位于第三脑室前部,常附着于重要的周围结构,具有出血性。因此,解剖这个肿瘤是非常困难的。在本研究中,我们报告了一名44岁男性的病例,他最初抱怨轻微头痛,并通过磁共振成像诊断为第三脑室均匀钆增强病变。先前医院活检病理诊断为CG。患者当时无神经功能障碍,但肿瘤逐渐生长,发现肿瘤2年后出现脑积水,患者出现短时记忆障碍及白天嗜睡。我们在显微镜和内窥镜下经前半球间经终末板入路切除肿瘤。在经过蝶窦手术的专用工具下,在有角度的刚性内镜下切除显微镜视图盲点处的残留肿瘤。大体切除肿瘤,组织病理诊断为CG。术后神经学表现包括轻微记忆障碍和下丘脑肾上腺功能障碍。术后3年未见肿瘤复发。内窥镜辅助的前半球间经终末板入路被确定为CG切除术的有效方法,手术并发症少,肿瘤无复发。
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引用次数: 0
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