椎管内脊膜瘤出血2例报道并文献复习

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1、［摘要］目的探讨椎管内脊膜瘤出血的临床特征、影像学表现及治疗方法。方法回顾性分析2015年8〜11月收治的2例椎管内脊膜瘤出血患者的临床资料，并结合国内外文献复习，分别就其临床表现、影像学特征、诊断及治疗进行探讨。结果1例患者磁共振（MRI）提示：T9〜10椎管内占位。另外1例患者磁共振提示：C7〜T1椎管内占位。2例患者全麻后在显微镜下行椎管内占位病变切除术+椎管减压术。术中见肿瘤均位于椎管髓外硬膜下，血供丰富，1例瘤内可见出血，另一例瘤内含陈旧血凝块。2例患者术中完整切除肿瘤，清除血凝块，术后病理均证实为脊

2、膜瘤。术后2例患者感觉运动均逐渐恢复。第1例患者发病到手术时间为6h，第2例患者为22h，第1例患者术后恢复较第2例患者好。结论椎管内脊膜瘤出血罕见，MRI是诊断的最佳手段，早期手术可明显改善患者的预后。［关键词］椎管；脊膜瘤；出血；硬膜下［中图分类号］R651.2［文献标识码］C［文章编号］1673-9701(2016)07-0116-03[Abstract]ObjectiveTostudytheclinicalfeatures，imagingfeaturesandtreatmentofspontaneous

3、intraspinalbleedingassociatedwithspinalmeningioma.MethodsTwocasesofspontaneousintraspinalbleedingassociatedwithspinalmeningiomabetweenAugusttoNovemberin2015wereretrospectivelyanalyzedandtheliteratureatdomesticandoverseaswerereviewed.Theclinicalmanifestations

4、，imagingfeatures，diagnosisandtreatmentwerediscussed.ResultsThemagneticresonanceimagingrevealedamassextendingfromT9toT10inonepatientandamassextendingfromC7toT1intheotherone.Thelaminectomywasperformedaftergeneralanesthesiaunderthemicroscopeandthemassinthespina

5、lcanalinthetwocaseswereresectedandthespinalcanalsweredecompressed.Thetumorsofthetwocaseswereshowedfullofbloodsupplyandbothlocatedatsubduralplaceinoperation.Thehemorrhagewasseeninthetumorinonecaseandoutmodedbloodclotwasseenintheother.Themassandbloodclotsofthe

6、twocaseswereremovedenblocintheoperation.Thepathologicalexaminationofthetwocasesrevealedmeningioma.Theneurologicalfunctionofthetwocases[Abstract]ObjectiveTostudytheclinicalfeatures，imagingfeaturesandtreatmentofspontaneousintraspinalbleedingassociatedwithspina

7、lmeningioma.MethodsTwocasesofspontaneousintraspinalbleedingassociatedwithspinalmeningiomabetweenAugusttoNovemberin2015wereretrospectivelyanalyzedandtheliteratureatdomesticandoverseaswerereviewed.Theclinicalmanifestations，imagingfeatures，diagnosisandtreatment

8、werediscussed.ResultsThemagneticresonanceimagingrevealedamassextendingfromT9toT10inonepatientandamassextendingfromC7toT1intheotherone.Thelaminectomywasperformedaftergeneralanesthesiaunderthemicr