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学科主题: 临床医学
题名:
Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma Clinical article
作者: Liang, Jian-tao1,2,3; Bao, Yu-hai1,3; Zhang, Hong-qi1,3; Huo, Li-rong4; Wang, Zhen-yu2; Ling, Feng1,3
关键词: cavernoma ; magnetic resonance imaging ; intramedullary ; neurosurgery ; spinal cord ; oncology
刊名: JOURNAL OF NEUROSURGERY-SPINE
发表日期: 2011-10-01
DOI: 10.3171/2011.5.SPINE10735
卷: 15, 期:4, 页:447-456
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Surgery
研究领域[WOS]: Neurosciences & Neurology ; Surgery
关键词[WOS]: CENTRAL-NERVOUS-SYSTEM ; VASCULAR MALFORMATIONS ; SURGICAL-MANAGEMENT ; ANGIOMAS ; DIAGNOSIS ; RESECTION ; BRAIN ; MRI ; HEMANGIOMAS
英文摘要:

Object. The authors conducted a study to assess the clinical pattern, radiological features, therapeutic strategies, and long-term outcomes in patients with intramedullary spinal cord cavernomas (ISCCs) based on a large case series.

Methods. This retrospective study identified 96 patients (60 males, 36 females) surgically (81 cases) or conservatively (15 cases) treated for ISCCs between May 1993 and November 2007. Each diagnosis was based on MR imaging and spinal angiography evidence. For all surgically treated patients, the diagnosis was verified pathologically. The neurological outcomes pre- and postoperatively, as well as long-term follow-up, were assessed using the Aminoff-Logue Disability Scale.

Results. The mean age at the onset of symptoms was 34.5 years (range 9-80 years). Of the lesions, 68 (71%) were located in the thoracic spine, 25 (26%) in the cervical spine, and only 3 (3%) in the lumbar spine. The median symptom duration was 19.7 months. The clinical behavior of the lesion was a slow progression in 73 cases and an acute decline in 23 cases. Long-term follow-up data (mean 45.8 months, range 10-183 months) were available for 75 patients (64 surgical cases and 11 conservative cases). In the surgical group, a complete resection was achieved in 60 patients, and incomplete resection was detected in 4 patients after operation. At the end of the follow-up period in the operative group, 23 patients (36%) improved, 35 (55%) remained unchanged, and 6 (9%) worsened. In the nonoperative group, 5 patients improved, 6 patients remained unchanged, and none worsened.

Conclusions. For differential diagnosis, spinal angiography was necessary in some cases. For most symptomatic lesions, complete microsurgical resection of the symptomatic ISCC is safe and prevents rebleeding and further neurological deterioration. However, in patients whose lesions were small and located ventrally in the spinal cord, one can also opt for a rigorous follow-up, considering the high surgical risk. (DOI: 10.3171/2011.5.SPINE10735)

语种: 英语
WOS记录号: WOS:000295301900019
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62511
Appears in Collections:北京大学第三临床医学院_神经外科_期刊论文

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作者单位: 1.Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing 100053, Peoples R China
2.Peking Univ, Hosp 3, Dept Neurosurg, Beijing 100871, Peoples R China
3.Capital Med Univ, Cerebrovasc Dis Res Inst, Beijing 100053, Peoples R China
4.Capital Med Univ, Minist Educ, Key Lab Neurodegenerat Disorders, Dept Physiol, Beijing 100053, Peoples R China

Recommended Citation:
Liang, Jian-tao,Bao, Yu-hai,Zhang, Hong-qi,et al. Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma Clinical article[J]. JOURNAL OF NEUROSURGERY-SPINE,2011,15(4):447-456.
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