颅内海绵状血管瘤的自然病程、影像学诊断和立体定向放射外科治疗

发布时间：2018-08-23 19:54

【摘要】：颅内海绵状血管瘤是较常见的血管畸形,可在颅内许多部位出现,主要表现为癫痫、出血,头痛和局灶性神经功能缺失等症状。术前主要依靠影像学方法进行诊断,而核磁共振是其最主要的诊断手段。在其自然病程的研究中,海绵状血管瘤的癫痫发生率要高于动静脉畸形等颅内病变,且伴有癫痫症状的患者其5年癫痫发生率要显著高于偶然发现的海绵状血管瘤患者。不同的文献报告的海绵状血管瘤出血率存在差异,可能与不同的出血定义以及存在出血簇集现象等因素有关。近年来不断有学者提出立体定向放射外科是一种安全有效的治疗方法,尤其是高风险,不能手术,位于脑功能区的海绵状血管瘤,并报告了立体定向放射外科治疗海绵状血管瘤取得的良好疗效,但仍需进一步评估其长期疗效和安全性。本文对颅内海绵状血管瘤的自然病程、影像学诊断和立体定向放射外科的治疗三个方面作一综述。
[Abstract]:Intracranial cavernous hemangioma is a common vascular malformation, which can be seen in many parts of the brain, including epilepsy, hemorrhage, headache and focal nerve loss. Preoperative diagnosis mainly depends on imaging methods, and MRI is the most important means of diagnosis. In the study of its natural course, the incidence of epilepsy in cavernous hemangioma is higher than that in intracranial lesions such as arteriovenous malformation, and the incidence of epilepsy in patients with epilepsy is significantly higher than that in patients with cavernous hemangioma discovered by accident. The bleeding rate of cavernous hemangioma reported in different literatures is different, which may be related to different definition of hemorrhage and haemorrhage clustering phenomenon. In recent years, some scholars have proposed that stereotactic radiosurgery is a safe and effective treatment, especially cavernous hemangioma with high risk, which can not be operated on and located in the functional area of the brain. The good effect of stereotactic radiosurgery on cavernous hemangioma is reported, but it is necessary to evaluate its long-term efficacy and safety. This article reviews the natural course, imaging diagnosis and stereotactic radiosurgery of intracranial cavernous hemangioma.
【作者单位】：中南大学湘雅医院神经外科;
【分类号】：R743

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