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1、JNeurosurg(Spine1)99:64–69,2003SurgicalmanagementoflumbosacralnerveroothemangioblastomasinvonHippel–LindausyndromeRUSSELLR.LONSER,M.D.,SCOTTD.WAIT,B.A.,JOHNA.BUTMAN,M.D.,PH.D.,ALEXANDERO.VORTMEYER,M.D.,MCCLELLANM.WALTHER,M.D.,LANCES.GOVERNALE,B.S.,AND
2、EDWARDH.OLDFIELD,M.D.SurgicalNeurologyBranch,NationalInstituteofNeurologicalDisordersandStroke;DiagnosticRadiologyDepartment,ClinicalCenter;andUrologicOncologyBranch,NationalCancerInstitute,NationalInstitutesofHealth,Bethesda,MarylandObject.Hemangiobl
3、astomasinthelumbosacralregionarerare,andtheauthorsofpriorreportshavenotdefinedthesur-gicalmanagement,histopathologicalfeatures,oroutcomeinagroupofpatientsafterresectionofthesetumors.Toidenti-fyfeaturesthatwillhelpguidetheoperativeandclinicalmanagement
4、oftheselesions,theauthorsrevieweddataobtainedinaseriesofpatientswithvonHippel–Lindausyndromewhounderwentresectionoflumbosacralnerverootheman-gioblastomas.Methods.Sixconsecutivepatients(threemenandthreewomen;meanageatsurgery39years[range31–48years])who
5、underwentoperationsforresectionoflumbosacralnerveroothemangioblastomaswereincludedinthisstudy.Themeanfollow-upperiodwas23months(range6–45months).Dataderivedfromexamination,hospitalcharts,operativefindings,histopathologicalanalysis,andmagneticresonance
6、imagingwereusedtoanalyzesurgicalmanagementandclinicalout-come.Theresectedtumorswerelocatedinthelumbar(fivecases)orsacral(onecase)regions;themeantumorsizewas2728mm3(range80–15,022mm3).Consistentwithcentralnervoussystem(CNS)regionalvariationofspaceavail
7、abletoaccommodatetheneuralcompressiveeffectofthehemangioblastomasize,themeantumorvolume(2728mm3)ofthesesymptomaticlesionswasmuchlargerthanthatofsymptomatichemangioblastomasresectedintheotherregionsoftheCNS.Histopathologicalexaminationshowedinfiltratio
8、noftheassociatednerverootbythehemangioblastomaineachcase.Infiveofthesixpatientscompleteresectionwasachieved,andinonepatientintraduralexplorationoftwoheman-gioblastomaswasperformed,butresectionwasnotachievedbecauseofmotorrootinvolvement.Inallca
