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儿童幕上的星形细胞瘤相对罕见,位于中线部位者更是如此。根据定义,第Ⅲ脑室肿瘤是指起于或充满Ⅲ脑室腔的肿瘤。实际上,星形细胞瘤通常是中轴外和脑室外的肿瘤侵犯了脑室壁。虽然其发病率很低,但由于第Ⅲ脑室和脑脊液通路的解剖位置以及肿瘤与重要神经结构及隐藏在深部之静脉的关系,对神经外科医生来说,这些情况给手术操作构成了难以克服的障碍。作者报告47例儿童的颅内肿瘤中,有3例星形细胞瘤位于中线部位,肿瘤均已侵犯脑室壁并引起了脑积水。例1.男,8岁。入院诊断为第Ⅲ脑室巨大肿瘤,压迫两侧侧脑室。首先施行两侧侧脑室脑脊液分流术,3周后经右侧脑室入路进行探查,肿瘤已不能全切。术后4天患儿死亡,尸解显示星形细胞瘤(Ⅱ～Ⅲ级)已侵犯中脑。例2.女,12岁。首发症状是右手进行性笨拙。入院时CT
Children’s astrocytoma is relatively rare on the screen, especially in the midline. By definition, a third ventricle tumor is a tumor that begins or fills the cavity of the III ventricle. In fact, astrocytomas usually invade the ventricular wall outside the midaxillary and outside the brain. Although its incidence is low, due to the anatomic location of the III ventricle and the cerebrospinal fluid pathway and the relationship between the tumor and important neural structures and veins hidden in deep veins, these conditions make it difficult for neurosurgeons to perform surgical operations. obstacle. The authors report that of the 47 children with intracranial tumors, 3 were astrocytoma located at the midline. The tumors had invaded the ventricular wall and caused hydrocephalus. Example 1. Male, 8 years old. Admission was diagnosed as a large tumor in the third ventricle, compressing both lateral ventricles. Firstly, cerebrospinal fluid shunts were performed on both sides of the lateral ventricle. Three weeks later, exploration was performed through the right lateral ventricle approach. The tumor could not be completely cut. Four days after the death of the child, autopsy showed that astrocytoma (II ~ III) has violated the midbrain. Example 2. Female, 12 years old. The first symptom is progressive awkwardness by the right hand. On admission CT