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題名 | Surgical Management and Long-Term Results of Trigeminal Neuralgia with Intracranial Tumors=腦瘤引起之三叉神經痛之手術經驗及長期預後 |
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作者 | 周德陽; 王有智; 張光雄; | 書刊名 | 中國醫藥雜誌 |
卷期 | 2:3 1997.09[民86.09] |
頁次 | 頁137-148 |
分類號 | 416.291 |
關鍵詞 | 腦瘤引起之三叉神經瘤; 血管引起之三叉神經痛; 三叉神經瘤; 顯微血管減壓術; 顱內腫瘤; Tumor-induced TN; Vessel-induced TN; Trigeminal neuralgia; Microvascular decompression; Intracranial tumor; |
語文 | 英文(English) |
中文摘要 | 為了研究腦瘤引起之三叉神經痛及血管引起之三叉神經痛手術之經驗及預後,於過去13年間,總共有390位病人接受血管減壓術,有35位接受腦瘤切除。腫瘤引起之三叉神經痛大約佔所有三叉神經痛7.7﹪。腦膜瘤於小腦橋腦角是最常見引起三叉神經痛之腫瘤(43﹪),皮質囊腫其次(28﹪),聽神經瘤(23﹪),而最少的是三叉神經瘤6﹪。37﹪之腦瘤引起之三叉神經痛有不典型之三叉神經痛症狀,而只有9﹪血管引起之三叉神經痛有不典型之三叉神經痛症狀(p<0.001)。有33位腦瘤(93﹪)可以全部切除腦瘤,做次全切除之病患有2位,腦瘤引起之三叉神經痛其治癒率是80﹪而血管引起之三叉神經痛之治癒率為86﹪。腦瘤引起之三叉神經痛其手術併發症為31﹪較高於血管引起之三叉神經痛患者(9﹪)(p<0.001)。腫瘤引起之三叉神經痛患者手術死亡率約3%,而血管引起之三叉神經痛死亡率約1%。腦瘤引起之三叉神經痛患者,其造成三叉神經痛之原因可能是腦瘤直接壓迫或是腦瘤壓迫腦幹間接造成血管壓迫三叉神經,或者兩者皆可能。腦瘤再生長或血管減壓術不足夠是造成腦瘤引起三叉神經痛再發原因。 |
英文摘要 | In order to study the efficacy of surgical management and the outcome in surgically treated patients with tumor-induced trigeminal neuralgia (TN) and vessel-induced trigerminal neuralgia over the past 13 years. There were 390 patients who received microvascular decompression and 35 patients who underwent tumor removal. Tumor-induced TN accounted for 7.7% of all TN cases. Meningioma in the cerebello-pontine angle was the most common type of tumor in TN patients(43%), followed by epidermoid cyst(28%), then acoustic neuroma (23%) and lastly, trigeminal neuroma(6%). Thirty-seven percent of tumor-induced TN patients had atypical TN symptoms but only 9% of vessel-induced TN patients had atypical TN symptoms (p<0.001). Total removal of tumor was achieved in 33 patients (93%). Subtotal removal of tumor was performed in 2 patients. The cure rates for tumor-induced TN and vessel-induced TN were 80% and 86% respectively. The incidence of surgical complications for tumor-induced TN (31%) was much higher than for vessel-induced TN(9%),(p<0.001). Mortality was low in tumor-induced TN (3%) an vessel-induced TN(1%). The cause of TN in all of these tumor patients was either directly due to tumor invasion 40% or from vascular compression 20% caused by tumor, or both 40% Residual tumor, tumor regrowth and insufficient vascular decompression were the main causes of recurrence in 70% tumor-induced TN patients. |
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