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髓母细胞瘤向脊髓蛛网膜下腔播散为众所熟知。而由脑的原发病灶纯粹地传播到脊髓中央管则在病理检查中罕见。Zumpano 曾报告过髓母细胞瘤向髓内扩展的病例,本文作者报道一例。患儿男性、11岁,80年8月相继发生头痛、恶心、呕吐,但无显著神经系统局灶体征。CT 脑扫描显示颅后窝中部肿块。同年9月手术切除颅后窝小脑蚓部肿瘤。病理检查报告为髓母细胞瘤。术后行颅后窝放射治疗(5500拉得)及第二颈椎脊髓放射治疗(4500拉得)。术后两个月发生创口脑脊液漏,并有链球菌脑膜炎。经抗菌治疗后炎症消退,漏口自愈。83年夏渐发生进行性步态不稳。偶有背痛。无大小便功能障碍。
The dissemination of medulloblastomas into the spinal subarachnoid space is well known. The transmission of the primary lesion from the brain to the central canal of the spinal cord is rare in pathological examination. Zumpano has reported cases of medulloblastoma expansion to intramedullary expansion, and the authors report one case. Males, 11 years old, and August 80 had headaches, nausea, and vomiting, but no significant focal neurological signs. A CT brain scan revealed a mass in the middle of the posterior fossa. In September of the same year, the posterior fossa cerebellar vermis tumors were surgically removed. Pathological examination was reported as medulloblastoma. Postoperative cranial fossa radiotherapy (5500 pull) and second cervical spinal cord radiation therapy (4500 pull). CSF leakage occurred two months after the operation and streptococcal meningitis occurred. After inflammation, the inflammation subsided and the leaked mouth healed. In the summer of 83, progressive gait instability gradually occurred. There is occasional back pain. No urine dysfunction.