颈髓髓内神经鞘瘤1例临床及病理报告

患者女．22岁，因渐起左侧肢体无力伴颈部胀痛7月入院。于1992年9月初无明显诱因出现左足活动不灵，穿鞋易掉，伴夜间阵发性颈部帐痛、咳嗽、打喷嚏时疼痛加剧，继而定上、下肢乏力，左下肢僵硬，迈步发紧，偶有小便失禁，无头鼎，呕吐，于1993年3月17日行X线颈椎摄片，示颈椎生理曲度变直，第3～4颈椎前下缘轻度骨质增生，第5，6颈椎后下缘见骨质增生。头部CT平扫正常．诊断“脑脉管炎”，给予青霉素、地塞米松治疗2周无效。     

T10髓内、髓外硬膜下并发脊索瘤1例报告及文献复习

脊索瘤是起源于胚胎脊索结构残余组织的先天性肿瘤,多见于骶尾骨、颅底部及脊柱,发生于脊髓者少见,本文报告1例罕见的发生于胸髓且为髓内、髓外硬膜下并发的脊索瘤.     

显微手术治疗颈髓髓内肿瘤

报道显微手术治疗５８例颈髓髓内肿瘤。获全肿瘤切除者５０例，占８６．２％；术后神经系统状态改善者４５例，占７７．６％。表明颈髓髓内肿瘤适宜作肿瘤全切除，手术时机选在患者处于中度神经系统障碍时为好；描述了不同种类肿瘤的手术方法，认为激光手术对脂肪瘤切除最有帮助。提出了术中注意事项和肿瘤全切除的判断标准；阐述了术前放疗的危害性；对治疗后脊髓变细也作了简要讨论。     

颈髓髓内星形细胞瘤切除及疗效观察

1994年5月1例颈髓髓内星形细胞瘤患者施行肿瘤全切除术，治愈。术前四肢瘫痪，术后经MRI复查及追踪观察1年无复发迹象，证明颈髓髓内星形形细胞病某些可以全切除且预后良好。     

高颈髓髓内肿瘤显微外科治疗分析

目的 探讨显微神经外科手术治疗高颈髓髓内肿瘤的方法及临床疗效.方法 回顾分析我院显微外科手术切除15例高颈髓髓内肿瘤的临床资料.其中达到镜下全切除9例,次全切除3例,部分切除或活检3例.结果 术后病理显示:室管膜瘤8例,星形细胞瘤5例,血管母细胞瘤2例.平均随访25个月,症状好转13例,无变化1例,1例症状加重.结论 对脊髓髓内病变应早期诊断,显微手术治疗高颈髓髓内肿瘤可取得较好疗效.     

颈髓肿瘤的显微外科治疗

目的 探讨颈髓肿瘤的显微外科治疗方法. 方法 根据肿瘤的不同部位和病理类型,对36例肿瘤(髓内12例,髓外24例)选择不同的手术人路和方法.结果 髓内肿瘤12例中10例获得全切,7例术后神经功能明显改善或稳定.髓外肿瘤24例中22例获得全切,23例术后神经功能明显改善或稳定.结论 颈髓肿瘤应采用显微外科技术治疗,能有效的保护脊髓组织及神经,减少神经功能障碍的进一步加重,提高手术全切率,改善预后.手术入路的选择应根据肿瘤的部位、大小、发展方向和病理类型选择不同的手术入路.     

颈髓髓内血管母细胞瘤的诊断与治疗

目的 探讨颈髓髓内血管母细胞瘤的诊断与治疗。方法 分析19例患者的MRI表现，及其手术治疗的效果。结果 这类肿瘤在MRI上可分为三型：A.空洞型，肿瘤大小不等，且继发延、脊髓空洞；B.囊肿型，为囊内小的附壁结节；C.实体型，为巨大的实体性肿瘤。所有患者均经手术全切除肿瘤，并经病理证实为血管母细胞瘤。术后患者神经系统状态好转者18例，加重1例。结论 颈髓MRI能对颈髓髓内血管母细胞瘤作出定位、定性诊断，并可将其分型，以利选择不同的手术方法；诊断时，还需与胸廓出口综合征和颈椎病相鉴别。认为颈髓髓内、即使累及延髓的血管母细胞瘤宜行积极手术治疗；手术方法随肿瘤类型不同而各异，最为重要是：需沿正确的界面分离，并应在离断供血动脉后切除肿瘤。     

脊索瘤合并垂体腺瘤1例

<正>1病例资料患者,女性,50岁,因双眼视力下降15年伴头痛、呕吐12d入院。入院时体格检查:右眼睑下垂,右眼球运动受限;右侧瞳孔直径约5 mm,左侧约4 mm,右瞳孔直接及间接对光反射均消失,左瞳孔直接及间接对光反射均灵敏;右眼视力0.25,左眼视力无光感;右侧视野向心性缩小;右侧颜面部温痛觉减退,伸舌略右偏;四肢肌力5级。血清学检查表示内分泌激素各指标基本正常。增强MRI(图1A、1B)示:右颞病变     

鞍区巨大软骨样脊索瘤1例

正1病例资料患者女性,23岁,因进行性头痛、右眼失明半年入院。外院查颅脑CT示(图1A):右颞部见一混杂密度影,约5.0 cm×4.0 cm,其内散在分布、大小不一的钙化影,周围脑室及脑池受压。我院查颅脑MRI示(图1B):鞍上及右侧鞍旁见团块状异常信号,呈等长T1、等长T2信号,形态不规则,大小约6.1cm×5.2 cm×5.5 cm,呈不均质强化,病灶侵入右侧海绵窦,包绕颈内动脉;脑干受压明显,向左后移位,视交叉及垂体柄显     

Cervical chordoma: case report

Chordomas of the cervical spine are rare. A case of a cervical chordoma is described. The initial radiological misinterpretation was due to the unavailability of CT myelography or MRI. Treatment of this disease is difficult, with multiple operations often required. Tumour bulk at diagnosis, completeness of surgical excision, availability of radiotherapy and biological behaviour of the chordoma are the main determinants of survival. Our case is interesting in terms of long survival which is 11 years to date. On reviewing the recent literature we have not found separate survival statistics for cervical chordoma, however, we have found 4 other cases of cervical chordoma with survival greater than 10 years.     

Cervical intramedullary melanocytoma: A case report and review of literature

Meningeal melanocytomas are rare tumours of the central nervous system, most commonly found in the intracranial compartment (posterior cranial fossa). Spinal lesions are uncommon, with the majority being intradural, extramedullary lesions. Intramedullary melanocytomas are extremely rare and are most commonly found in the thoracic region. We report a patient with cervical intramedullary melanocytoma and review the available literature regarding this rare pathology.     

复发性上段颈椎脊索瘤一例

正患者男性,58岁,主因颈部疼痛3个月,于2009年2月10日入院。患者3个月前无明显诱因出现颈部疼痛,以左后侧显著,呈持续性钝痛,转头时加重、休息后缓解,同时伴转头活动受限,于当地医院行颈椎CT和MRI检查证实上段颈椎占位性病变(图1)。遂行病变组织穿刺活检术,术后病理学检查证实为脊索瘤。为求进一步手术治疗至我院就诊。患者自发病以来精神、睡眠好,饮食正常,大     

Spinal intramedullary cysticercosis: A case report

The parasitic infection of the central nervous system due to Cystiacercus cellulosae usually affects the intracranial structures. The spinal form of neurocysticercosis is uncommon, anatomically confirmed cases range from 0.77 to % among all cases of neurocysticercosis. Even fewer cass appear as spinal intramedullary cysticercosis (SIC); no than 49 confirmed cases have been reported in the literature. One case of SIC is reported here. The patient showed both motor and sensory symptoms that improved after One year later he is working again and only pperreflexia has been detected. Although the magnetic resonance imaging studies showed a cystic intramedullary lesion it was considered to be spinal glioma; only after histologic Study was the exact diagnosis made. The clinical symptomatology in these cases is due to compression of descending and ascending spinal tracts; the clinical diagnosis may be suspected in countries where cysticercosis is endemic. Modern neuroimaging techniques provide higher possibilities of accurate diagnosis; however, it can only be established with certainty by histologic study of the surgical specimen.     

胸髓内畸胎瘤1例报告

脊髓内畸胎瘤为含有三个胚层组织的先天性肿瘤，极为罕见。脊髓内畸胎瘤发病年龄较轻，肿瘤多位于圆椎马尾区，位于胸段的更为少见。我院2006年2月收治了经手术和病理证实为胸髓内畸胎瘤1例，现报告如下。     

Solitary intramedullary tuberculoma: report of a case

A case of an isolated tuberculoma of the spinal cord is reported. The 22 years old male patient came to the hospital with paraplegia and had a laminetomy performed for a compression of the spinal cord by a tumor mass. The histopathological study showed the presence of the acid-fast bacili in the tissue. After specific treatment the patient recovered partially.     

Multiple spinal intramedullary cavernous angioma: case report

Spinal cavernous angiomas frequently accompany to cranial cavernous angiomas. Multiple spinal cord cavernous angiomas are very rare and to authors knowledge, only one case has been described having multiple intramedullary cavernous angiomas without cranial involvement until now. In this report, we present a case with acute paraplegia who had thoracic and cervical intramedullary cavernous angiomas and normal cranial magnetic resonance imaging.     

Infrasellar craniopharyngioma mimicking a clival chordoma: a case report

An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of an entirely infrasellar craniopharyngioma, with extensive clival destruction, mimicking a clival chordoma. Relevant literature on the subject is reviewed.     

Endoscopic management of a lower clival chondroid chordoma: case report

We report herein a case of lower clival chondroid chordoma, focusing on the surgical procedure of endoscopic endonasal surgery. A 36-year-old woman presented with progressive headache, right shoulder pain, and right hypoglossal nerve palsy. Computed tomography (CT) and magnetic resonance (MR) imaging revealed an extradural tumor located in the lower clivus, including the anterior aspect of the foramen magnum, deeply compressing the medulla and upper cervical spinal cord. Endoscopic endonasal surgery was performed via two nostrils. Since the basiocciput was destroyed by the tumor, removal of the tumor allowed identification of the middle clivus superiorly, the anterior arch of the atlas inferiorly, and anteromedial parts of occipital condyles bilaterally without drilling the basiocciput. The tumor was removed except for laterally and inferiorly extended lesions. Pathological diagnosis was chondroid chordoma. Postoperative course was uneventful, and the patient was discharged without further neurological deterioration. Endonasal endoscopic surgery provided safe and reliable tumor resection for a lower clival lesion. We believe that this minimally invasive procedure should be considered as an alternative to traditional surgical treatment.