중뇌에 발생한 해변상 혈관종의 수술적 제거 - 증례 보고-
Surgical Removal of Cavernous Angioma in the Midbrain - A Case Report -
소속 상세정보
임병철/Byung Chol Rim
민경수/이무섭/김동호/김영규/Kyung Soo Min/Moo Seop Lee/Dong Ho Kim/Young Gyu Kim
KMID : 0359819980270040545
Abstract
서론
뇌 간(Midbrain)에 발생한 해면상 혈관종(Cavernous hemangioma)의 치료에는 수술적 적
출에 의한 위험성으로 최근 정위적 방사선 치료가 시도되고 있다. 그러나 뇌간에 발생한 해
면상 혈관종의 경우 그 출혈의 빈도가 높고 출혈시 사망 또는 이환율이 높아 수술적 접근이
가능하면 수술적 완전 적출을 고려 할 수도 있다. 저자 등은 중뇌에 발생한 출혈성 해면상
혈관종을 완전 적출(Occipital transtentorial approach)하여 좋은 결과를 얻었기에 보고한다.
#초록#
We report a case in which a cavernous hemangioma in the midbrain was completely
removed. Two days prior to hospitalization, a 32-year-old female patient, who had
complained of intermittent headache, presented with deteriorated consciousness.
Neurological examination revealed anisocoria, no response to lights, diplopia in a
superior and inferior direction, increased deep tendon reflexes, and an unceratin response
to examination. Radiology revealed a deep cavernous hemagioma in the midbrain and
there was evidence of recurrent bleeding, especially on MRI. To remove the cavernous
hemangioma, she underwent extrabentricular drainage(EVD), craniotomy(using the
suboccipital transtentorial approach), and ventriculoperitoneal shunt and recovered. She
had now been followed up for 1 year and 6 months, and is leading a normal life.
We have concluded that results may be possible with in the case of symptomatic
cavernous hemangioma, and awareness precise anatomical location, a well designed
approach and of possible neurologic deficits, this is so even in the midbrain.
키워드
Cavernous hemangioma; Midbrain; Rebleeding;
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