颅内脑外型海绵状血管瘤的伽玛刀治疗 - 第三军医大学学报.docVIP

颅内脑外型海绵状血管瘤的伽玛刀治疗 耿明英1 张子义2 程远3 许民辉1 沈光建1 （1.第三军医大学第三附属医院大坪医院野战外科研究所神经外科,重庆，400042； 2.重庆医科大学第二附属医院神经外科，400016; 3.山东省东阿县人民医院放射科，252201） [摘要] 目的：探讨伽玛刀治疗颅内脑外海绵状血管瘤的临床疗效，并总结伽玛刀治疗经验。方法：收集2002年5月-2009年5月间位于海绵窦旁颅内脑外海绵状血管瘤6例，采用直接伽玛刀治疗4例，开路手术切除后伽玛刀治疗例，平均有效照射剂量为12.9Gy（11-16Gy），视神经接受剂量均小于9.0Gy（2.4-9.0Gy）。结果：全部病例随访6月～9年。5例症状改善，1例仍有复视。MRI显示病灶消失1例，缩小4例，无变化1例。结论：对病灶难以手术或难以耐受手术的颅内脑外海绵状血管瘤，伽玛刀治疗是一种安全有效的治疗方法。 [关键词] 脑外海绵状血管瘤；伽玛刀治疗 Gamma knife treatment of extracerebral cavernous hemangiomas GENG Mingying1, XU Minhui1, Shen Guangjian1, Department of Neurosurgery，Institute of Surgery Research, Daping Hospital, Third Milihary Medical University, Chongqing 400042. Zhang Ziyi2. Department of Radiology,Donge County People,s Hospital, Liaocheng Shandong 252201. Chengyuan3, Department of Neurosurgery, Second Affiliated Hospital of Chongqing University of Medical Science, Chongqing 400016.) ABSTRACT: OBJECTIVE: Intracranial extracerebral cavernous hemangiomas（ECA）may develop in the cavernous sinus. These tumors pose diagnostic as well as therapeutic challenges to neurosurgeons during attempted removal. We discuss our experience using gamma knife radiosurgery (GKS) to cure Intracranial extracerebral cavernous hemangiomas. It’s also a opportunity for us to share experience for gamma knife usage. METHODS: 6 symptomatic patients with ECAH underwent GKS between May of 2000 to May of 2009. The hemangiomas were located in the cavernous sinus. The average volume of ECAH was 4.3cm3 (range from 3.8- 6.8 cm3).The presenting symptoms included headache, orbital pain, diplopia, ptosis, proptosis and impaired visual acuity(6 patients). Four patients treated by GKS based on clinical and imaging criteria. 2patients had first microsurgical partial excision biopsy and then cured by GKS. The average of irradiation dose -------------------------------------------------------- 第一作者 耿明英，380904661@QQ.com 通讯作者 张子义， delivered to the margin was12.9 Gy (range 11-16 Gy). The dose to the opt