目的 探讨脑干海绵状血管瘤的诊断和治疗.方法 对2004年1月至2007年12月手术切除的6例脑干海绵状血管瘤进行回顾性分析.结果 病变均全切除,患者无手术死亡.术后1例患者新出现外展神经麻痹,5例术前神经功能障碍基本恢复.1例患者术前呼吸机辅助呼吸2个月,术后呼吸无恢复,半年后死于肺部感染.5例患者术后格拉斯哥结局量表评分平均4.6分(平均随访时间为23个月),未见复发.结论 脑干海绵状血管瘤符合手术指征的,利用显微神经外科技术可以全切,愈后良好.对于脑干深部或无症状的海绵状血管瘤,可以保守治疗.放疗对脑干海绵状血管瘤的效果不肯定,应持谨慎态度.%Objectives To evaluate the diagnsis and surgical treatment of cavernous malformations of the brainstem (CMBs). Methods From January 2004 to December 2007, 6 patients (1 woman and 5 men; mean age 31.4 years) had 6 CMBs in the pans (4), medulla oblongata (1) and oblongata-cervical junction (1). Surgical in-dications for CMBs were progressive focal neurological deficits. Transvemian approach with midline suboccipital cra-niotomy were used for the lesions. Results CMBs were totally removed from all patients undergoing microsurgerical procedures. Neurological deficits were improved in 5 patients after operation. One patient who used respirator 2 months before operation died 6 months later due to pulmonary infection. Follow up was available in 5 patients.The average postoperative Glasgow Outcome Scale score was 4.6, with a mean follow-up period of 23 months.Conclusions These CMBs can be resected safely using minimal invasiveness techniques when the patients have symptomatic hemorrhage and harbor lesions that approach the pial surface.
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