儿童脑内海绵状血管瘤的显微手术治疗

目的探讨儿童脑内海绵状血管瘤（CCM）的手术治疗。方法对1997～2005年我科收治的28例儿童CCM病例资料进行回顾性分析。对有癫痫发作和病灶出血的患儿采取手术治疗。术前利用神经导航系统和功能核磁共振进行病灶精确定位，采用“锁眼”手术入路和切口开颅，并全部在显微镜下进行病灶切除。结果26例患儿共有32个病灶获得全切除，其中包括5例多发患儿共切除病灶11个，无手术死亡。住院期间，9例癫痫患儿术后有2例仍有癫痫发作，17例术前神经功能障碍者有13例术后得到改善，3例同术前，1例加重。随访8个月～9年，没有发现病灶原发部位的再出血以及复发，2例癫痫患儿症状已得到控制，3例神经功能障碍者已基本恢复正常。结论在严格手术指征的前提下，我们主张儿童CCM尽早手术治疗。采用微创手术切除儿童CCM，预后良好。

Microsurgery for the cerebral cavernous malformations in children

Objective To review our operative results in treating cerebral cavernous malforma- tions(CCH)in children.Methods Twenty-eight children(male 17 and female 11,age ranged from 4 to 15 years)with CCM were admitted into our institution between 1997 and 2005.Of these,26 pa- tients presenting with seizures and symptomatic hemorrhage underwent the surgical treatment.The neuronavigation and functional MRI were performed preoperatively to localize the CCM lesions.Key- hole incisions and microsurgeries were carried out.Results Thirty-two lesions were removed in 26 pa- tients.There was no mortality.Eleven lesions in 5 patients with multiple CCM were also successfully reseeted.Two patients developed seizures before discharge.Neurological deficits significantly im- proved in 13 cases,remained unchanged in 3 cases and became worse in 1 case.There was no recur- rence or re-haemorrhage during the 8-9 month follow-up period.Conclusions Microsurgery is the treatment of choice for CCM in selected children.