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听神经瘤造成( )|垂体腺瘤造成( )|颅咽管瘤造成( )|脑膜瘤造成( )

发布日期:2020-08-20

听神经瘤造成( )|垂体腺瘤造成( )|颅咽管瘤造成( )|脑膜瘤造成( )
A

单侧听力下降

B

颅骨内板腐蚀破坏

C

双颞侧视野缺损

D

桥脑小脑角综合征

E

多饮、多尿及鞍上钙化

试题解析

垂体腺瘤

垂体腺瘤起源于蝶鞍内脑垂体细胞,发生率较高,约占颅内肿瘤的12%,多属良性,以中年人多见,男女比例无明显差异。瘤体直径在1cm以内且局限于鞍内者称微腺瘤;直径1~3cm突破鞍隔者称大腺瘤;直径在3cm以上且向鞍旁和视丘下部伸展者称为巨大腺瘤。巨大腺瘤向鞍上发展可达第三脑室内,向蝶鞍发展可累及海绵窦,伸入颅中窝。向后可长入脚间池和斜坡,向下可突破鞍底进入蝶窦内或鼻咽部。根据肿瘤的酸碱染色法分类,将垂体腺瘤分为嫌色性腺瘤、嗜酸性腺瘤和嗜碱性腺瘤及混合性腺瘤、恶性腺瘤。恶性腺瘤生长快,体积大,向周围浸润广泛,瘤细胞大小不一,并有核分裂。

中文名
垂体腺瘤
外文名
pituitary adenoma

颅咽管瘤

颅咽管瘤是位于鞍区或鞍旁区的生长缓慢的中枢神经系统良性肿瘤。颅咽管瘤是起源于颅咽管的上皮细胞或Rathke's囊的残留(造釉型)或由原始口凹残留的鳞状上皮细胞化生而来(乳头型)。颅咽管瘤可从垂体-下丘脑轴的任何一点发生并沿此轴发展,肿瘤可从位于蝶鞍到大脑的第三脑室,大约50%的肿瘤起源于第三脑室底水平的漏斗和/或灰结节区域,主要向第三脑室发展。患者可出现头痛、视力损害和由中枢性尿崩症导致的多饮多尿等症状,儿童可出现发育迟缓,成人可出现性功能障碍和下丘脑综合征(如体温调节紊乱、水电平衡紊乱)。典型的颅咽管瘤属于组织学上低级别肿瘤(WHO Ⅰ级),但由于肿瘤位于下丘脑-垂体区域,肿瘤和手术对该区域的损伤可导致患者不良的预后和结果。

外文名
craniopharyngioma
常见症状
内分泌功能障碍、视觉障碍和颅高压等
就诊科室
神经外科、内分泌科或眼科

听神经瘤

听神经瘤是指起源于听神经鞘的肿瘤,为良性肿瘤,确切的称谓应是听神经鞘瘤,是常见颅内肿瘤之一,占颅内肿瘤的7%~12%,占桥小脑角肿瘤的80%~95%。多见于成年人,高峰在30~50岁,20岁以下者少见,儿童单发性听神经瘤非常罕见,迄今为止,均为个案报道。无明显性别差异。左、右发生率相仿,偶见双侧性。临床以桥小脑角综合征和颅内压增高征为主要表现。

别名
听神经鞘瘤
就诊科室
神经外科
常见病因
多源于第Ⅷ脑神经内耳道段
外文名
acoustic neuroma
多发群体
30~50岁人群
常见症状
桥小脑角综合征、颅内压增高征

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