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神经鞘瘤罕见,约占全部颅内肿瘤的8%以下,而副神经神经鞘瘤极罕见。本文介绍2例:例1,女性,50岁,头痛10年,伴有颈枕部疼痛运动时增剧,疼痛向右肩放散,曾有3次短暂意识丧失。查体:头左歪,右侧副神经轻度麻痹,其余颅神经正常,双侧腱反射亢进四肢肌张力增高,右下肢力弱,Romberg 氏征(+),双侧视乳头水肿伴出血;右侧椎动脉造影示基底动脉移向斜坡,小脑后下动脉延髓段被抬高,小脑蚓部与扁桃支伸直,闪烁造影在后颅窝有4×3×4厘米之病变,手术证明在枕骨大孔部有6×4×4厘米之肿瘤,靠近脑干处与右侧副神经密切相连,组织学证实为神经鞘瘤,术后完全恢复。例2,男性,29岁,进行性四肢瘫,主诉左侧肢体(包括左侧躯干)感觉减低与尿潴留1年,查
Schwannoma is rare, accounting for about 8% of all intracranial tumors, and paraneoplastic schwannoma is extremely rare. This article describes two cases: Case 1, female, 50 years old, with headache for 10 years, accompanied by increased pain during exercise of the neck occipital, pain spreading to the right shoulder, there have been three brief loss of consciousness. Physical examination: the head left iliac, the right side of the auxiliary nerves mild paralysis, the rest of the cranial nerves normal, bilateral tendon reflexes hyperthyroidism limb muscle hypertonia, right lower limb weakness, Romberg’s sign (+), bilateral optic papilla edema with hemorrhage; The right vertebral artery angiogram showed that the basilar artery moved to the slope, the medulla oblongata was elevated, the cerebellar vermis and the amygdala branch were straightened, and the scintigraphy showed a 4×3×4 cm lesion in the posterior fossa. The operation proved that The occipital foramen has a 6×4×4 cm tumor, which is closely connected to the right accessory nerve near the brain stem. Histology proved to be a schwannomas, and it completely recovered after surgery. Case 2, male, 29 years old, with progressive quadriplegia, complained of a decrease in sensation and urinary retention for 1 year on the left limb (including the left torso).