目的 探讨脑外伤患者发生迟发性尿崩症的诊断及治疗方法。方法 回顾性分析我科近5年脑外伤后发生迟发性尿崩症的19例患者。根据临床症状、实验室检查及头颅MRI检查早期明确迟发性尿崩症的诊断并给予及时处理。结果 所有患者的尿量均恢复正常，其中2例需终生服用12去氨基282右旋2精氨酸加压素（DDAVP）替代治疗。结论 脑外伤后迟发性尿崩症通过临床表现、实验室检查及头颅MRI检查明确诊断，行抗利尿激素制剂和口服的抗利尿药物治疗后效果满意。

高颈段髓外肿瘤，以良性病变多见，MRI对其早期定位诊断有较大价值，是目前诊断高颈段肿瘤最可靠的手段。尽早显微手术切除及良好的术后护理和监护措施，是获得手术成功的关键。

目的 提高颅后窝血管网织细胞瘤的诊疗水平。方法 回顾总结31例颅后窝血管网织细胞瘤诊断方式及显微外科手术治疗效果。结果 31例肿瘤（囊性23例，实性8例），全切除30例（囊性23例，实性7例），次全切除1例（实性1例），术后神经功能明显改善27例（囊性23例，实性4例），加重3例（均为实性肿瘤），死亡1例（实性）。随访期间有3例复发（囊性1例，实性2例，其中1例实性为颈髓段再发）。结论 明确肿瘤解剖关系及血供情况，囊性肿瘤采用锁孔入路，实性肿瘤骨窗开颅，采用显微外科技术是提高疗效的重要方法。

Objective: The object of this study was to analysis the therapeu-tic effects of microsurgical excision in cases with the large or giant cerebellopontine angle meningioma. Methods: We retro-spectively analyzed the 56 patients who suffered from the large or giant cerebellopontine angle meningioma and underwent the microsurgical therapy, for which the suboccipital-retrosigmoidal approach was adopted in 38 cases, the temporal-occipital cra-niotomy, presigmoidal approach in 6 cases, the temporal-occipi-tal craniotomy, inferotemporal tentorium cerebelli approach-ing cases, and the temporal-occipital craniotomy, supratentorial or infratentorial allied approach in 4 cases. Results: The tumors of 44 cases were all resected (Simpson 1, 11), with a total resection rate of 78.6%, and there was no operative mortality. After sur-gery, symptoms improved in 40 cases and remained unchanged in 10 cases. Among 54 cases, recrudescence was seen in 2 cases (3.7%) and being able to take care of themselves in 50 cases (92.6%) at 6 months through 6 years follow-up after surgery. Conclusion: A rationally selected surgical approach, a micro-scopic technology applied in the operation to appropriately treat and protect vein, nerve and brain stem, which can ideally excise the tumors, together can increase the survival ability of patients.

随着显微外科的发展，应用显微外科技术切除脑部肿瘤已越来越受到重视和关注[1，2]。第四脑室脑膜瘤极罕见，由于该肿瘤早期诊断困难，同时手术切除难度大，应用显微外科手术可全部切除肿瘤，且可减少或避免术后并发症，从而获得较好的疗效。我科于1998年12月收治1例巨大的第四脑室脑膜瘤，现结合文献进行讨论。