Intramedullary spinal cord cavernous malformations: report of ten new cases
Intramedullary spinal cord cavernous malformations: report of ten new cases
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DOI：
10.1007/s10143-003-0302-9
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发表时间：
2004-04-01
影响因子：
2.8
通讯作者：
Cantore, G
中科院分区：
文献类型：
--
作者：
Santoro, A;Piccirilli, M;Cantore, G
脊髓海绵状畸形（SCCM），曾经被认为是非常罕见的，已被诊断更频繁地出现以来，MRI。除了1992年至1993年手术治疗的6例个人病例外，作者在此报告了1993年4月至2001年1月手术治疗的另外10例病例。这些患者包括5名男性和5名女性，手术时年龄从12岁到69岁不等。5名患者的SCCM位于胸部，5名患者位于颈部。在7例病例中，畸形在软脑膜表面隆起，而在其他3例中，由于含铁血黄素的存在，软脑膜下变色。所有病例均完全切除。术后，2例患者出现术前下肢轻瘫一过性恶化。在2.2至9.2年（平均5.7年）的随访中，9例患者完全恢复运动功能，而1例患者术前下肢轻瘫严重，保持静止。术后6 ~ 12个月，每例患者至少随访1次MRI检查。如前所述，作者证实，症状性SCCM的治疗选择是全手术切除，以避免复发和进一步出血的可能性。手术结果结合了低死亡率和高的功能恢复概率，特别是当下肢轻瘫不严重和相对较新的发病。
Spinal cord cavernous malformations (SCCM), once thought to be extremely rare, have been diagnosed more frequently since the advent of MRI. In addition to the six personal cases surgically treated between 1992 and 1993 and already described in the literature, the authors report here a further ten cases operated on between April 1993 and January 2001. These involved five males and five females whose ages at operation ranged from 12 to 69 years. The SCCM were thoracic in five patients and cervical in five. In seven cases, the malformations bulged on the surface of the pia mater, while in the other three there was subpial discoloration due to the presence of hemosiderin. Removal was total in all cases. After surgery, two patients presented transient worsening of preoperative paraparesis. At follow-up ranging from 2.2 to 9.2 years (mean 5.7), nine patients had made complete motor recovery while one, in whom preoperative paraparesis had been severe, remained stationary. At least one follow-up MRI investigation was performed in each patient 6 to 12 months after operation. As previously reported, the authors confirm that the treatment of choice for symptomatic SCCM is total surgical excision in order to avoid recurrences and the possibility of further hemorrhage. Surgical outcome combines low mortality with a high probability of functional recovery, especially when paraparesis is not severe and of relatively recent onset.