Neurotological Manifestations of fourth Ventricle Tumors

目的：第四腦室上接小腦下貼腦幹，故由此源生的腫瘤常會因壓迫小腦或腦幹，而在神經耳科學上有特殊的表現。反之小腦或腦幹的腫瘤，亦會侵犯第四腦室。在過去八年內，我們共經驗5例第四腦室腫瘤，特提出報告。病人及方法：自1991年1月至1998年12月，計9694名頭暈新鮮例，均接受一系列的聽力平衡功能檢查，其中45例屬腦腫瘤，而5例發生在第四腦室。結果：5例第四腦室腫瘤包括，1例表皮樣囊種、1例室管膜瘤、1例星狀細胞瘤、1例海綿狀血管瘤、1例乳癌的腦轉移。除頭暈症狀外，步態失調4例，眩暈3例，耳鳴3例、嘔吐、重聽、頭痛則各2例。其中4例有異常眼振。本症預後不佳，5例中有4例在兩年內死亡。結論：當一名暈病人、表現有步態失調、持續性嘔吐與中樞性眼振，如兩側性注視眼振、向下眼振或持續性眼振時，須考慮患第四腦室腫瘤的可能性。

關鍵字

第四腦室；步態失調；眼振；眼振電圖

並列摘要

Objective: The area of the fourth ventricle is particularly difficult to evaluate owing to its relatively small size and unique shape. However, this area encompasses many vital structures including the brainstem as its floor, and the cerebellum as its lateral wall and roof. Therefore, a fourth ventricle tumor presents some vital neurotological manifestations. Five cases of fourth ventricle tumors that occurred over the past 8 years are presented herein. Patients and Methods: From January 1991 to December 1998, a total of 9694 patients with vertigo/dizziness received a battery of audiological and neurotological tests. Forty-five (0.4%) cases were diagnosed as having brain tumors, five of which were in the fourth ventricle. Results: The five tumors included one epidermoid cyst, one ependymoma, one astrocytoma, one cavernous angioma, and one metastatic breast breast cancer. In addition to dizziness, other symptoms included ataxia in four cases, vertigo in three, tinnitus in three, and vomiting, hearing loss, headache in two cases, respectively. Four cases displayed abnormal nystagmus. The prognosis was poor, and four cases passed away within 2 years. Conclusions: A fourth ventricle tumor should be considered, when a patient displays ataxia, persistent vomiting, and central nystagmus, such as bilateral gaze nystagmus, downbeat nystagmus, or persitent unilateral nystagmus.

並列關鍵字

fourth ventricle ； ataxia ； nystagmus ； electronystagmography (ENG)

國際替代計量

Neurotological Manifestations of fourth Ventricle Tumors

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