儿童后颅凹室管膜瘤(附243例分析)

摘要

@@ 室管膜瘤是儿童期比较常见的颅内肿瘤,多数位于后颅凹.现将我院1958～1981年收治,并经病理证实的儿童后颅凹室管膜瘤(包括室管膜母细胞瘤)243例的诊治经验介绍如下.rn临床资料rn一、性别及年龄rn本组男性145例(59.7%),女性98例.年龄分布:4个月～3岁32例,4～7岁76例,8～12岁99例,13～15岁36例.年龄:最小者为4个月,平均就诊年龄为8.1岁.%This paper reports 243 cases of ependymoma of posterior fossa in children,accounting for 81.5%of pediatric intracranial ependymoma cases seen in the same period.Intracranial hypertension at an early stage is attributed to obstiuction of the 4th ventricle and lqwer opening of aquaeductus by the tumor.Staggering gait,ataxia and nystagmus may result from the involvement of the cerebellum.Paralysis of the Ⅵ and Ⅶ cranial nerves can be caused by the involvement of the cranial nuclei in the brain stem or compression upon the cranial nerves.Ventriculography is not only valuable in locating the tumors but also helpful to planning the operation.Emphasis should be directed to the evaluation of relationship between the tumor and the floor of the Ⅳventricle before and during the operation.In the absence of attachment to or invasion of the brain stem,the tumor can be subjected to total or subtotal excision.Follow.up study showed poor prognosis.Nearly half of the patients died within one year after operation and only 6.1%of them survived for 5 years or longer.About 3.1%developed matastasis owing to dislodged tumor cells and,therefore,routine postoperative radiotherapy on the brain and the spinal cord is reeommonded.