소뇌 혈관모세포종 ; 임상적 발현 및 수술결과
Cerebellar Hemangioblastoma : Clinical Presentations and Surgical Outcome
소속 상세정보
김충현/Choong Hyun Kim
백광흠/김재민/김영수/고용/오석전/김광명/김남규/Kwan Heum Paik/Jae Min Kim/Young Soo Kim/Yong Koh/Suck Chon Oh/Kwang Myung Kim/Nam Kyu Kim
KMID : 0359819980270030369
Abstract
결론
저자들은 최근 7년간 실시하였던 421례의 뇌종양 수술중 조직학적으로 소뇌의 혈관모세포
종으로 확진된 11례에 대한 후향적 분석을 시행하였다. 대부분의 임상증세 및 징후는 두개
강내압상승 및 소뇌기능 장애에 의하여 발생되었으며 다혈구증도 18%에서 관찰할 수 있었
다. 종양의 수술적적출은 소뇌반구 및 소뇌충부에 발생된 경우 전적출이 가능하였으나 뇌간
부로 파급된 종양은 모두 아전 적출하였으며 술후 경과도 불량하였다. 또한 수술시 철저한
지혈이 요구되며 특히 뇌간으로 파급된 종양은 술후 뇌신경 기능장애에 의한 합병증을 예방
하기 위하여 유의하여야 한다.
#초록#
In order to analyze clinical presentations and surgical outcome, we studied eleven
cases of cerebellar hemangioblastoma from among a series of 421 intracranial tumors
treated over a period of seven years.
The proportion of male patients was 2.7 time that of females and the age peak
appeared between 30 and 50 years(mean age : 37.7 years old). The common clinical
presentations were headache(73%), dizziness(55%), unilateral cerebellar dysfunction(45%),
and nausea or vomiting(36%). In our serious there were two cases of cranial nerve
palsy associated with von Hippel-Lindau(VHL) disease. Polycythemia that normalized
postoperatively appeared in two of eleven cases. Radiologic studies showed nine cystic
tumors, six in the cerebellar hemisphere and three in the cerebellar vermis, and three
solid tumors extended into the brain stem.
After aspiration of the cyst, careful removal of the mural nodule gave good results in
more than 70% of patients. Because the tumor extended into the brain stem, however,
three solid lesions were resected subtotally. Postoperative complications developed in four
patients, and in three of these, the lesion extended into the brain stem.
In conclusion, major clinical features were due to increased intracranial pressure, and
varying expression of cerebellar and cranial nerve deficits was characteristic. To
determine the resectability of lesions and to minimize surgical morbidity, extremely
careful clinical and neuroradiological observation is essential.
키워드
Hemangioblastomas; Cerebellum; Headache; Polycythemia;
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