血管中心性胶质瘤所致癫痫的外科治疗并文献复习——附2例报道.pdfVIP

血管中心性胶质瘤所致癫痫的外科治疗并文献复习 附2 例报道 刘长青 周健 栾国明 单位：北京三博脑科医院 【摘要】目的 总结血管中心性胶质瘤 （angiocentric glioma，AG)临 床、电生理、影像学及病理学特点，探讨其诊断、治疗及预后。 方法 回顾性总结手术治疗的 2例血管中心性胶质瘤伴有癫痫的病 例。2例AG患者均为男性，年龄在14～22岁，平均 18岁。癫痫的 初发病年龄在9～13岁，平均11岁。首发症状均为癫痫，根据病变 所处的部位不同，采取不同的手术人路。1例行左额颞开颅颞前叶及 内侧结构加病变切除术，另1例因核磁共振所示异常信号肉眼不能分 辨，在导航下行右颞顶枕开颅颞叶病变加致痫灶切除术。术中均在浅 麻醉状态下行皮层脑电图监测。结果 病理诊断为AG。术后均无并发 症，经过6～12个月的随访，2例AG患者癫痫发作均完全消失(Engel 级)。结论 AG确诊依赖于病理组织学检查，肿瘤细胞围绕血管形成 菊形团样结构和EMA 点状阳性是其独特的组织学特点，电镜检查对 确定肿瘤组织来源及鉴别诊断意义重大。手术完整切除术后无需放化 疗，且可有效控制癫痫发作。 关键词: 血管中心性胶质瘤；癫痫；外科手术；病理 Surgical treatment forEpilepsy induced byangiocentric gliomaandliterature review (analysis of6cases) Liu Changqing, Zhou Jian, Luan Guoming． Neurosurgery，San-Bo Brain Science InstituteEpilepsy Center. [Abstract]Objective Study clinical, electrophysiological, imaging and pathological features of angiocentric glioma (AG), discuss the diagnosis, treatment and prognosis. Method Reviewed retrospectively 2 cases AG of associated with epilepsy through surgical treatment. Two cases of AG patients were male, aged 14 to 22 years, an average of 18 years of age. Early age of onset of epilepsy in 9- 13 years, mean 11 years old. Initial symptoms are seizures. According to the different parts of the lesion, we took different surgical approaches. A routine take left frontotemporal craniotomy and medial temporal lobe structures plus the former lesion resection. Another case took the right temporal-parietal-occipital craniotomy, temporal lobe lesions Canada epileptogenic resection in the navigation beause MRI shows abnormal signal naked eye can not distinguish. Patients in both the downlink in the light anesthesia state cortical EEG monitoring. Results Pathological diagnosis was AG. Postoperative there was no any complic