Abstract
14例の頸静脈孔神経鞘腫に対し,神経症状の出現・増悪を最小限にすべく,GKRS,術式の異なる摘出術を適宜選択する治療戦略を試みてきたので.その実際と治療成績について報告した.対象は,症候性6例,無症候性8例で,脳幹圧迫がなければGKRSを選択し,脳幹圧迫があれば摘出術を選択した.後者は,硬膜内型ではlateral suboccipital approachにて頭蓋内のみ摘出し,頸静脈孔内の残存腫瘍にGKRSを追加した.硬膜内外型では,頸部進展のためGKRSが不可能な症例に対し,transjugular approach (/transcervical)を選択した.平均観察期間4年6カ月において,症候性6例の既存の神経症状の改善は困難であったが,無症候性8例は,1例を除いて新たな神経症状は出現せず,ほぼ満足できる治療結果が得られ,一考すべき治療法と考えられた.
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