Surgical Treatment of Cervicomedullary Junction Hemangioblastoma with Intraventricular Hemorrhage

手術治療延腦－頸部交界部位血管母細胞瘤併腦室內出血

蘇鈺凱(Yu-Kai Su) ； 葉宜憲(Yi-Hsien Yeh)

《台灣癌症醫學雜誌》 26卷6期 (2010/12) Pp. 263-269

https://doi.org/10.6323/JoCRP.2010.26.6.5

摘要

一位病人罹患延腦－頸部交界部位的血管母細胞瘤併發腦室內出血。症狀包括意識喪失，四肢癱瘓，以及高血壓。在緊急放置腦室外引流管及腦脊髓液引流後，意識狀態由深度昏迷進步至意識清醒。血管攝影檢查顯示一個位於延腦－頸部交界部位由脊椎動脈供應，顯影強烈的腫瘤。腦部核磁共振顯示血管供應豐富的腫瘤併腦幹及腦室內出血。病人之後接受了開顱腫瘤切除手術。術後肢體力量回復，眼球運動協調改善。良好的手術治療仍能提供如此嚴重疾病患者良好恢復的機會。

關鍵字

血管母細胞瘤 ； 延腦－頸部交界 ； 腦室內出血

並列摘要

A case of cervicomedullary junction hemangioblastoma with intraventricular hemorrhage is presented. The patient developed disturbance of consciousness, quadriplegia, and hypertension. The consciousness level improved from deep coma to clear consciousness after emergent external-ventricular drainage tube insertion and cerebral spinal fluid drainage. Brain MRI with contrast study showed tumor mass at the level of cervicomedullary junction with strong contrast enhancement. Angiography exam showed abnormal tumor stain supplied from the meningeal branch of the right vertebral artery and right posterior inferior cerebellar artery. Suboccipital craniectomy with delicate tumor removal under microscopy was performed. The pathology report concluded hemangioblastoma. Muscle power of the patient's four limbs and internuclear ophthalmoplegia recovered after the surgery. In this case, successful microneurosurgery was able to provide excellent prognosis of the devastating disease.

並列關鍵字

hemangioblastoma ； cervicomedullary junction ； intraventricular hemorrhage