岛叶相关胶质瘤术后远期脑梗塞特征及因素分析并文献回顾

Characteristics of postoperative further infarction and its influencing factors in insular-involving gliomas: a retrospective analysis and review of literature

摘要:

目的 本文对岛叶相关胶质瘤患者偶见的术后远期梗塞进行特征及因素分析。方法 随访150余例岛叶相关胶质瘤病例, 筛出7例术后远期梗死病例行特征及因素分析并文献回顾。结果 平均年龄42.86±7.58岁, 6例男性。6例合并高血压糖尿病, 6例有长期吸烟史, 肿瘤位置分布均匀, 均达全切且病理结果均含星形成分。术后平均梗塞发生时间11.6±7.1个月。6例肿瘤与大脑中动脉关系密切, 5例经侧裂入路, 5例术后神经功能障碍加重。5例于基底节区见点及片状异常核磁信号。结论 本病中具有血管危险因素的中老年男性、肿瘤与血管关系密切、病理结果含星形细胞成分、侧裂入路达全切、术后神经功能障碍加重的患者应当警惕术后远期梗塞的发生。

Abstract:

Objective To investigate the characteristics of occasional postoperative further infarction (PFI) and its influencing factors in insular-involving gliomas (IIG).Methods A total of 150 IIG patients were followed up. The characteristics and influencing factors of 7 PFI patients were investigated, and related literature was reviewed.Results The mean age of PFI patients was 42.86±7.58 years, and 6 patients were males. Six patients were accompanied by hypertension and diabetes, and 6 patients had a long history of smoking. The locations of the tumors were homogeneously distributed, all the tumors were totally resected, and the pathological results all revealed astrocytoma components. The mean time to PFI was 11.6±7.1 months. Tumor was closely correlated with the middle cerebral artery in 6 patients, transsylvian approach was used in 5 patients, and neurological disorder was aggravated in 5 patients. Spot- and sheet-shaped nuclear magnetic resonance signals were seen in the basal ganglia region in 5 patients.Conclusions IIG patients who are elderly males, have vascular risk factors, show a close correlation between tumor and artery, have astrocytoma components in pathological results, achieve total resection via the transsylvian approach, and suffer from aggravation of neurological disorder after surgery should be cautious of PFI.