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脊髓肿瘤合并脑积水非常少见。我们近年发现3例,现报告如下。 例1 男,52岁,因进行性双下肢麻木,无力10个月,头痛、呕吐3个月于1985年7月入院。检查:神志清楚,双眼底视乳头水肿及出血,T_4水平以下深浅感觉明显减退,双下肢肌力Ⅰ级,未引出病理反射。腰穿压力3.8kPa,脑脊液蛋白120mg％。脊髓碘油造影示T_3水平梗阻,近似杯口状。胸椎CT扫描示T_4～T_3水平椎管内肿瘤。头颅CT扫描示双侧脑室及三脑室轻度扩张。手术:T_4～T_8椎板切除探查,发现髓内肿瘤向髓外生长,边界不清,考虑为胶质瘤,瘤体取活检,硬膜敞开减压。病理报告:纤维性星形细胞瘤。术后头痛、呕吐消失,视乳头水肿消退,腰穿压力1.37kPa,脑脊液蛋白110mg％,下肢肌力恢复至Ⅱ级。术后2周复查头颅CT扫描,脑室扩大无明显改变。术后19天出院。
Spinal cord tumor with hydrocephalus is very rare. We found three cases in recent years, are as follows. Example 1 Male, 52 years old, due to progressive numbness of both lower extremities, weakness 10 months, headache, vomiting 3 months in July 1985 was admitted. Check: Consciousness, bilateral papillary edema and hemorrhage, T_4 level below the level of sensory decline was significantly lower, lower limb muscle strength Ⅰ, did not lead to pathological reflex. Waist wear pressure 3.8kPa, cerebrospinal fluid protein 120mg%. Spinal iodine oil angiography showed T_3 horizontal obstruction, similar to cup mouth. Thoracic CT scan showed T_4 ~ T_3 level spinal canal tumor. Head CT scan showed mild dilatation of both ventricles and ventricles. Surgery: T_4 ~ T_8 laminectomy exploration and found intramedullary tumor to the extramedullary growth, the boundary is unclear, consider glioma, tumor biopsy, dural decompression. Pathology report: Fibrous astrocytoma. Postoperative headache, vomiting disappeared, optic disc edema subsided, lumbar puncture pressure 1.37kPa, cerebrospinal fluid protein 110mg%, lower limb muscle strength recovered to Ⅱ level. 2 weeks after the review of cranial CT scan, no significant changes in ventricular enlargement. 19 days after discharge.