儿童颅内海绵状血管瘤并发癫痫的手术治疗

Surgical treatment of intracranial cavernous angioma with epilepsy in children

摘要:

目的 明确儿童颅内海绵状血管瘤并发癫痫的手术治疗效果。方法 回顾我院从2010年2月至2014年5月经手术治疗27例儿童颅内海绵状血管瘤并发癫痫患儿的病例资料。分析儿童海绵状血管瘤的临床特点,随访患者手术后癫痫缓解情况。手术后癫痫治疗情况用Engle's分级进行评估,并对手术效果及预后进行分析。结果 所有患者均行手术切除。术后1例基底节区病变切除后出现对侧肢体偏瘫,经治疗后到随访时神经功能已恢复至术前状态。1例术后出现颅内感染,经治疗后好转出院。手术后癫痫缓解良好,Engle's分级1级25例,2级1例,3级1例。患者中无死亡及严重并发症患者。结论 儿童颅内海绵状血管瘤并发癫痫手术治疗可有效治疗癫痫,并可避免海绵状血管瘤再次出血而改善患者预后。对多发病变及长期癫痫患者术前需充分评估。

Abstract:

Objective To clarify the effects of surgical treatment of intracranial cavernous angioma with epilepsy in children.Methods The clinical data of 27 children with intracranial cavernous angioma and epilepsy who underwent surgery in our hospital from February 2010 to May 2014 were analyzed retrospectively. The clinical characteristics of intracranial cavernous angioma in these children were analyzed. The remission of epilepsy was followed up for these children after surgery and evaluated by Engle's classification. Surgical effects and prognosis were analyzed.Results All patients underwent surgical resection. After surgery, 1 patient experienced contralateral hemiplegia after resection of cavernous angioma in the basal ganglia and from the time after treatment to follow-up visit, this patient's neurological function had been restored to the preoperative status. One patient experienced intracranial infection after surgery, and was improved and discharged after treatment. The remission of epilepsy after surgery was good, with 25 cases of Engle's class I, 1 case of Engle's class Ⅱ, and 1 case of Engle's class Ⅲ. No death or severe complication occurred.Conclusions The surgical treatment is an effective way to handle intracranial cavernous angioma with epilepsy, and can prevent recurrence of hemorrhage related to cavernous angioma and improve prognosis. Patients with multiple cavernous angioma lesions and long-term epilepsy should be fully evaluated before surgery.