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Brainstem Cavernoma Treated with Cone-based Stereotactic Radiosurgery

腦幹海綿狀血管瘤之圓錐形準直儀立體定位放射手術

Abstracts


腦幹海綿狀血管瘤的治療包括神經外科手術和立體定位放射手術。我們報告兩位腦幹海綿狀血管瘤的案例接受圓錐形準直儀立體定位放射手術。案例一:一位44歲女性病患,腦幹海綿狀血管瘤合併右側橋腦出血。於發病後幾個月,她逐漸恢復了神經功能。腦部磁振影像發現左側橋腦另一個增生的海綿狀血管瘤。病患接受直線加速器立體定位放射手術,處方劑室為14 Gy,分兩次治療。於接受放射手術後,沒有發現新的神經功能缺損。於追蹤的腦部磁振影像發現,左側橋腦的海綿狀血管瘤逐漸縮小,沒有放射治療相關之腦水腫發生。案例二:一位43歲的男性病患,過去病史有左側眼眶海綿狀血管瘤,於1997年接受過外科手術及放射治療。於追蹤時發現在側第四腦室屋頂環池有一個0.7 cm的海綿狀血管瘤。病患接受直線加速器立體定位放射手術,處方劑量為18 Gy,分兩次治療。於追蹤的腦部磁振影像發現,海綿狀血管瘤表現出良好的治療反應。

Parallel abstracts


The treatment of brainstem cavernoma includes neurosurgery and stereotactic radiosurgery (SRS). We reported two cases with brainstem cavernoma treated with linear accelerator (LlNAC) cone-based stereotactic radiosurgery.CASE 1: A 44 year-old female patient survived from brainstem cavernoma with bleeding into right pons. She recovered her neurological function gradually in months. Another growing cavernoma at left pons was noted by magnetic resonance imaging (MRI) of brain. It was treated with cone-based stereotactic radiosurgery. The prescribed radiation dose was 14 Gy in two fractions. No new neurological deficit was noted after radiosurgery. On the regular follow-up of brain MRI, the cavernoma over left pons remitted gradually, and no cerebral edema related to radiosurgery was observed.CASE 2: A 43 year-old male patient with history of left orbital cavernoma status post operation and radiation therapy in 1997 had a 0.7 cm cavernoma at left ambient cistern of the 4th ventricle roof. Cone-based stereotactic radiosurgery was performed. The prescribed radiation dose was 18 Gy in two fractions. On the regular follow-up brain MRI the cavernoma demonstrated very good treatment response.

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