PDF(Pubmed)
Abstract：
Subependymomas are benign tumors of the ventricles that grow from the ventricular wall into the cerebrospinal fluid spaces within the brain, obstructing the flow of the cerebrospinal fluid and causing obstructive hydrocephalus. It is estimated that ependymomas represent between 0.2% and 0.7% of all intracranial tumors. They arise most frequently in the fourth ventricle (50-60%) and the lateral ventricles (30-40%). We present the case of a 50-year-old patient, previously diagnosed with an intraventricular process, admitted in our clinic. At neurological examination, the patient was cooperative, bradylalic, and bradypsychic, with right hemiparesis, postural and balance disorders, and occasionally sphincteric incontinence. MRI with contrast described a left intraventricular tumor, in the frontal horn of the left lateral ventricle with homogeneous appearance, with a maximum diameter of 50 mm and base of insertion at the adjacent ependyma of the foramen of Monro, which determined obstructive hydrocephalus. Total resection of the left intraventricular cerebral tumor was achieved. Histopathological analysis revealed a subependymoma. Postoperative recovery was slowly favorable, with significant neurological improvement. At neurological examination at three-month follow-up, the patient\'s right hemiparesis and unsystematized balance disorders improved. A contrast-enhanced CT scan was performed, highlighting left frontal sequelae hypodensity corresponding to the operated tumor, enlarged left lateral ventricle without active hydrocephalus, and no sign of tumor recurrence. At six-month follow-up, clinico-radiologic findings coincide with those from three-month follow-up. Subependymomas are slow-growing (grade 1) tumors and generally have a favorable prognosis. Unfortunately, due to their anatomical level, multiple complications can arise, caused from obstructive hydrocephalus complications, such as cognitive dysfunction and incontinence. Tumor resection should be complete, a successful operation being a challenge for every neurosurgeon.
摘要：
室管膜下瘤是脑室的良性肿瘤，从脑室壁生长到脑内的脑脊液空间，阻塞脑脊液的流动并引起梗阻性脑积水。据估计，室管膜瘤占所有颅内肿瘤的0.2％至0.7％。它们最常见于第四脑室(50-60%)和侧脑室(30-40%)。我们介绍一个50岁的病人,以前被诊断患有脑室内过程，在我们的诊所住院。在神经系统检查中，病人很合作，Bradylalic,和bradypsychic，右偏瘫,姿势和平衡障碍，偶尔括约肌性尿失禁。增强MRI描述了左心室内肿瘤，在左侧脑室的额角具有均匀的外观，最大直径为50毫米，底部插入门罗孔的相邻室管膜，这决定了梗阻性脑积水。实现了左心室脑肿瘤的完全切除。组织病理学分析显示室管膜下瘤。术后恢复缓慢良好，神经明显改善。在三个月随访的神经系统检查中，患者的右偏瘫和非系统平衡障碍得到改善。进行了对比增强CT扫描,突出显示与手术肿瘤相对应的左额叶后遗症低密度，左心室扩大，无活动性脑积水，没有肿瘤复发的迹象.在六个月的随访中，临床放射学发现与三个月的随访结果一致。室管膜下瘤是生长缓慢的（1级）肿瘤，通常预后良好。不幸的是,由于它们的解剖水平，可能会出现多种并发症，由梗阻性脑积水并发症引起，如认知功能障碍和失禁。肿瘤切除应该完成，成功的手术对每个神经外科医生来说都是一个挑战。
