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shu zhong shen jing dian sheng li jian ce xia qie chu qiao nao hai mian zhuang xue guan liu 1 li
Author(s): 
Pages: 868-868
Year: Issue:  5
Journal: The Journal of Practical Medicine

Abstract: 患者男,57岁,病史7 d,表现为右侧肢体无力及感觉减退。神经系统查体提示右侧肢体肌力Ⅲ级,左侧Ⅴ级,右侧肢体痛温觉减退,无饮水呛咳及声音嘶哑,无面瘫。头部MRI提示左侧桥脑类圆形异常信号,边界清晰,T1高信号,T2高低混杂信号。术前面神经功能评估:术前面神经功能分级为1级。诊断:桥脑海绵状血管瘤。插管全麻后神经电生理监测仪(XLTEX 32导)示左侧面神经运动诱发电位刺激阈值为293 V,500 Hz,2 Pulses,手术采取后正中入路,暴露桥脑背侧后,定位肿瘤位于面丘附近脑干内,切开脑干前行同心圆双极刺激探针刺激脑干表面,确定面丘部位,刺激量为0.14 mA(图1),然后在面丘上方剖开脑干,行脑干内肿瘤切除,肿瘤切除后左侧面神经运动诱发电位刺激阈值为313 V,500 Hz,2 Pulses(刺激阈值)。术后查体:无发热,神清,言语流利,双侧瞳孔等大等圆,直径约3.0 mm,对光反射灵敏,无面瘫,双眼活动自如、无眼震,双侧口角对称,伸舌居中,右下肢肌力3+级,右上肢肌力3+级,左侧肢体肌力5级,肌张力正常,右侧肢体痛觉减退。生理反射正常引出,病理征阴性。术后面神经功能同术前。术后病理诊断:桥脑海绵状血管瘤。术后1个月复查头部MRI提示肿瘤切除完整,未见肿瘤复发。
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