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Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma Clinical article
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
2011-10-01
DOI10.3171/2011.5.SPINE10735
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
引用统计
被引频次:21[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/62511
专题北京大学第三临床医学院_神经外科
北京大学医学部管理机构_北京大学医学部校医院
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
推荐引用方式
GB/T 7714
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.
APA Liang, Jian-tao,Bao, Yu-hai,Zhang, Hong-qi,Huo, Li-rong,Wang, Zhen-yu,&Ling, Feng.(2011).Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma Clinical article.JOURNAL OF NEUROSURGERY-SPINE,15(4),447-456.
MLA Liang, Jian-tao,et al."Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma Clinical article".JOURNAL OF NEUROSURGERY-SPINE 15.4(2011):447-456.
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