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我院收治了2例小脑蚓部少突胶质细胞瘤,经手术治疗后效果满意,现报告如下。 [例1]女性,68岁。因行走不稳2年,言语不清伴进行性头痛,呕吐,进食呛咳3个月入院。查体:神态清理,消瘦体质,表情淡漠,强迫头位,不能答话,老花视力。眼底视乳头水肿,眼球呈水平震颤。四肢肌张力低,腱反射减弱,平衡障碍及运动性共济失调。站立不稳。头颅CT扫描:后颅凹小脑蚓部占位性病变伴梗阻性脑积水。患者年高体弱,一般状况差。于术前一日做右侧脑室枕角置管外引流。次日在全麻下经后颅凹正中入路行肿瘤全切术。肿瘤体积:4.5cm×5.0cm×5.5cm,瘤体外观呈暗红色,与正常脑组织易分离,无明显包膜,中等硬度,切面呈灰红色,瘤体周边有点状钙化,中心部位有小片状出血及坏死灶。术后病理报告为少突胶质细胞瘤,复查病理切片无误。术后半年复查CT,脑室基本恢复正常,无肿瘤残存。 [例2]男性,70岁。因站立,行走不稳3年,持续性头痛伴喷射状呕吐1个月入院。查体:神情,表情淡漠,头位固定,言语不清。眼底双侧视乳头轻度水肿,眼球震颤不明显,四肢肌张力低,腱反射引出不满意,平衡障碍,站立不稳。头颅CT及MRI均提示,小脑蚓部占位性病变并累及左侧小脑半球,梗阻性脑积水。在较充分
In our hospital, 2 cases of cerebellar vermis oligodendroglioma were treated and the results were satisfactory after the operation. The report is as follows. [Example 1] Female, 68 years old. 2 years due to unstable walking, speechless with progressive headache, vomiting, coughing for 3 months admitted to hospital. Examination: demeanor, weight-loss physique, indifferent expression, forced head position, can not answer, presbyopia. Fundus papilledema, the eye was tremor level. Low limb muscle tension, tendon reflexes, balance disorders and ataxia. Unstable Head CT scan: posterior fossa cerebellar vermis space occupying lesions with obstructive hydrocephalus. Patients, frail, poor general condition. On the day before surgery to do the right ventricle occipital angle catheter drainage. The next day after general anesthesia via cranial median approach total tumor resection. Tumor volume: 4.5cm × 5.0cm × 5.5cm, tumor appearance was dark red, and normal brain tissue easily separated, no obvious capsule, medium hardness, section was gray-red, tumor around a little bit of calcification, the center is small Flaky bleeding and necrosis. Postoperative pathology report of oligodendroglioma, review pathology section correct. After six months of review CT, ventricles returned to normal, no tumor remains. [Example 2] Male, 70 years old. Due to standing, walking instability for 3 years, persistent headache with jet-like vomiting 1 month admitted. Physical examination: expression, indifference, fixed head, unclear words. Fundus bilateral papilledema mild edema, nystagmus was not obvious, limb muscle tension is low, tendon reflex leads to dissatisfaction, balance disorders, standing instability. Head CT and MRI are prompted, cerebellar vermis space occupying lesions and involving the left cerebellar hemisphere, obstructive hydrocephalus. In more full