Lateral ventricle tumors: Surgical strategies according to tumor origin and development - A series of 72 cases
Lateral ventricle tumors: Surgical strategies according to tumor origin and development - A series of 72 cases
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DOI：
10.1227/01.neu.0000333772.35822.37
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发表时间：
2008-06-01
期刊：
影响因子：
4.8
通讯作者：
Carosi, Illuminato
中科院分区：
文献类型：
--
作者：
D'Angelo, Vincenzo A.;Galarza, Marcelo;Carosi, Illuminato
目的：侧脑室肿瘤的最佳手术治疗仍存在争议。我们进行了一项回顾性研究，这些病变的患者治疗与手术策略的基础上，肿瘤的起源：原发性或继发性心室和相关的transependymal development.METHODS：共72例患者接受手术治疗侧脑室肿瘤。患者平均年龄为39岁（范围：6个月至78岁）。53%的患者发生颅内压升高，其次是精神障碍或精神症状（32%）和运动障碍（21%）。44例患者采用经皮质入路，28例患者采用纵裂入路; 16例患者采用经胼胝体入路，12例患者采用脾旁入路。在选定的患者进行神经心理学测试。结果：全切除术在82%的患者。65%的肿瘤为良性和低度恶性肿瘤。无手术死亡，并发症发生率为11%。经皮质组术后癫痫（5.9%）显著增加。平均随访时间为55个月; 59%的患者恢复良好，中度残疾。在术后神经心理学测试中，在6名患者（8%）中观察到言语记忆缺陷。结论：侧脑室肿瘤可根据肿瘤的起源和发展情况选择手术入路，经胼胝体入路是首选，但对于经室管膜生长或较大的原发性或继发性脑室肿瘤，经皮质入路是更好的选择。
OBJECTIVE: Optimal surgical management in lateral ventricle tumors remains controversial. We conducted a retrospective study of patients with these lesions treated with a surgical strategy on the basis of tumor origin: primary or secondary ventricular and associated transependymal development.METHODS: A total of 72 patients underwent surgery for lateral ventricle tumors. The mean patient age was 39 years (range, 6 mo to 78 yr). Raised intracranial pressure occurred in 53% of patients, followed by mental disturbances or psychiatric symptoms (32%) and motor deficits (21%). The transcortical approach was used in 44 patients, and an interhemispheric approach was used in 28 patients; a transcallosal approach was used in 16 patients, and a parasplenial approach was used in 12 patients. Neuropsychological tests were performed in selected patients.RESULTS: Total resection was performed in 82% of patients. Sixty-five percent of tumors were benign and low-grade tumors. There was no surgical mortality, and the morbidity rate was 11%. Postoperative epilepsy (5.9%) was significantly increased in the transcortical group. The mean follow-up period was 55 months; 59% of patients achieved good recovery and moderate disability. In postoperative neuropsychological testing sessions, deficits in verbal memory were observed in six patients (8%). Final morbidity correlated well with preoperative clinical condition and pathological diagnosis.CONCLUSION: Lateral ventricle tumors can be treated hest by careful selection of the approach according to tumor origin and development it. Overall, the transcallosal approach is preferred, but in patients with transependymal growth or large primary or secondary ventricular tumors, the transcortical is a better option.