目的 探讨延髓肿瘤的治疗策略，以达到最佳预后。 方法 回顾分析2007年1月－2010年12月19例延髓肿瘤患者的临床资料，其中18例经外科手术治疗和病理证实，1例通过影像学确诊。 结果 12例血管网状细胞瘤中，11例手术全切，1例手术次全切；2例室管膜瘤均手术全切；2例海绵状血管瘤分别手术全切及伽马刀治疗；3例胶质瘤均手术部分切除。18例手术治疗患者术后神经功能障碍明显好转者13例，无明显变化者3例，2例因术后严重并发症死亡；1例伽马刀治疗患者症状好转。术后随访6～48个月，平均24个月。11例恢复工作，4例生活可自理，2例因肿瘤复发死亡。结论 术前通过MRI检查、术中神经电生理监测及熟练的显微外科技术是外科治疗优势，伽马刀治疗延髓较小肿瘤有着损伤小的优点，因此制定合理的治疗策略有利于提高患者生存质量。
目的 探讨显微切除延髓实体性血管母细胞瘤术中电生理监测的意义。 方法 2007年7月-2009年8月，在电生理监测下显微切除13例延髓实体性血管母细胞瘤，观察切除程度、死亡率及术后脑干功能，并对电生理监测下的手术技巧进行讨论总结。 结果 完全切除13例延髓实体性血管母细胞瘤，术后因呼吸功能衰竭死亡1例，6个月脑干机能状态较术前保持或改进10例。 结论 延髓实体性血管母细胞瘤切除术中行神经电生理监测有助于提高手术效果，改善预后。
ObjectiveTo evaluate the magnetic resonance imaging (MRI) manifestations, pathological and clinical characteristics, and treatment outcomes of multiple sclerosis (MS) patients with new lesion in medulla oblongata (MO).MethodsPubMed, EBSCO, and Springer databases between January 1st, 2000 and May 1st, 2018 were searched with the combined keywords of " multiple sclerosis” and " medulla oblongata”. Furthermore, the MS patients’ MRI manifestations, pathological and clinical characteristics, and treatment outcomes were summarized.ResultsA total of 18 papers were involved, in which 26 patients were included. The lesions in MO were mainly showed by wedge-shape (9/20), and round or oval-shape (9/20) in axial head MRI. Inflammatory cells infiltration and acute demyelination in the new lesions of MO had been displayed by autopsy reports of two MS patients. The new lesions in MO mainly referred to various types of nystagmus (9/26), left ventricular apical ballooning syndrome (LVABS) (8/26), neurogenic pulmonary edema (NPE) (6/26), and acute heart failure (6/26). Nucleus tracts solitaries (NTS), along with dorsal motor nucleus of the vagus nerve and medial reticular formation (MRF), was related to LVABS and NPE. Intercalatus nucleus, Roller nucleus and/or autonomic nerve structure were related to various types of nystagmus.ConclusionsIn axial head MRI, the new MS lesions in MO were mainly wedge-shape and round or oval-shape. Beyond that, the new MS lesions in MO could involve NTS, dorsal motor nucleus of the vagus nerve, MRF, intercalatus nucleus, Roller nucleus and/or autonomic nerve structure, resulting in special clinical features, such as, nystagmus, LVABS, NPE, and acute heart failure. Corticosteroid is still the main treatment to relieve the clinical manifestations caused by new MS lesions in MO.