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报道1949～1979年72例松果体区肿瘤手术治疗结果,对临床分型和手术方法的选择提出新的见解.72例平均年龄24岁,男性占63%.松果体区肿瘤的临床分型:典型三联症为:颅内压增高、动眼神经障碍及内分泌紊乱.本组中按临床表现不同可区分为五种类型.一、颅内压增高:64例.二、眼症综合征:19例,双眼协同运动障碍、动眼神经障碍、瞳孔变化、视野缺损等.有些征状有典型定位意义,如Parinaud征伴瞳孔散大示大脑脚尤其是内纵束受累,Parinaud征伴眼球协同运动障碍示额叶皮质或额核束在后白连合平面受累.三、内分泌综合征:20例,系间脑或松果体受累之表现,诸如水电介质紊乱伴尿崩症、高钠综合征,脂代谢、血糖及植物神经功能紊乱等.性早熟、性腺机能减退则提示下丘脑或单纯松果体功能障碍,四、神经综合征:44例,小脑和锥体束受累表现.五、精神综合征:22例,常早期出现,有定位价值.如意识障碍示大脑脚受累;记忆障碍示穹窿和丘脑内侧区受累;饮食过多和情感行为的失常示Ⅲ脑室底受累等.
The results of surgical treatment of pineal region tumors in 72 cases from 1949 to 1979 were reported, and new insights were given to the selection of clinical types and surgical methods. The average age of 72 patients was 24 years old and 63% of men were male. The clinical scores of pineal region tumors were reported. Type: typical triad: increased intracranial pressure, oculomotor nerve disorders and endocrine disorders. According to different clinical manifestations in this group can be divided into five types. First, increased intracranial pressure: 64 cases. Second, eye syndrome : 19 cases, synergetic dyskinesia of both eyes, oculomotor disorder, pupillary change, visual field defect, etc. Some of the symptoms have typical localization significance. For example, Parinaud’s concomitant dilated pupils indicate involvement of the brain’s feet, especially the medial longitudinal bundles. Parinaud’s sign is associated with the eyeballs. Synergistic dyskinesia indicates frontal cortex or frontal nucleus bundles are involved in posterior white commissure plane involvement. Endocrine Syndrome: 20 cases with intersystemic brain or pineal involvement, such as hydroelectric disorders with diabetes insipidus, high sodium syndrome , lipid metabolism, blood glucose and autonomic dysfunction, etc. Precocious puberty, hypogonadism suggest hypothalamic or simple pineal dysfunction, four, neurological syndrome: 44 cases, cerebellum and pyramidal involvement performance. Syndrome: 22 cases, often appear early , There is a positioning value. If the disturbance of consciousness shows that the brain and feet involved; memory impairment shows the inner area of the thalamus and the involvement of the thalamus; excessive eating and emotional behavior disorders show III ventricular floor involvement.