Diagnosis and surgical treatment of sporadic meningioangiomatosis
Diagnosis and surgical treatment of sporadic meningioangiomatosis
复制标题
DOI：
10.1016/j.clineuro.2013.01.021
复制
发表时间：
2013-08-01
影响因子：
1.9
通讯作者：
Wang, Yin
中科院分区：
文献类型：
--
作者：
Feng, Rui;Hu, Jie;Wang, Yin
目的：探讨散发性脑膜血管瘤病（MA）的临床特点、影像学特征、手术治疗及预后。方法：回顾性分析华山医院神经外科2002年至2011年收治的10例经组织病理学确诊的MA患者的病历，所有患者在开颅手术前均出现症状性癫痫发作。磁共振成像（MRI）和/或计算机断层扫描（CT）是所有病例术前诊断的主要放射学检查。结果：所有患者均接受开颅手术，对MA病灶进行大体全切除（GTR）。术后随访8～108个月，平均42.7个月，中位40.5个月。在任何情况下均未发现放射学复发。 8例患者（80.0%）术后症状完全缓解（其中1例出现延迟缓解），2例（20.0%）在使用多种抗癫痫药物（AED）后仍偶尔出现癫痫发作。结论：虽然MA病例相当罕见，且术前常被误诊，但通过患者年龄、症状性癫痫发作和放射学特征三者综合考虑，可以合理地获得正确的术前诊断，至少是鉴别诊断。 （CT 和 MR）。 MA 是可以治愈的，预后良好，因为大多数患者在手术治疗后不再出现癫痫发作和复发。 (C) 2013 Elsevier B.V. 保留所有权利。
Objective: To discuss the clinical characteristics, radiological features, surgical treatment and prognosis of sporadic meningioangiomatosis (MA).Methods: We retrospectively analyzed the medical records of ten histopathologically confirmed MA patients who were treated in the Department of Neurosurgery of Huashan hospital from 2002 to 2011. All of the patients presented with symptomatic seizure attacks before craniotomy surgeries. Magnetic resonance imaging (MRI) and/or computed tomography (CT) were the main radiological examination for preoperative diagnosis of all cases.Results: All patients underwent craniotomy surgeries with gross total resections (GTRs) of the MA lesions. Postoperative follow-ups range from 8 to 108 months, in average 42.7 months, median 40.5 months. No radiological recurrence can be found in any case. Eight patients (80.0%) have achieved total symptomatic remission after surgeries (one of them underwent delayed remission), while two (20.0%) are still suffering from seizure attacks infrequently under several antiepileptic drugs (AEDs).Conclusion: Although MA cases are quite rare and usually misdiagnosed presurgically, a correct preoperative diagnosis, at least a differential diagnosis, can be rationally achieved via a triad of patients' ages, symptomatic seizure attacks and radiological features (both CT and MR). MA is curable and the prognosis is excellent since most patients became free of seizure and recurrence after surgical treatments. (C) 2013 Elsevier B.V. All rights reserved.