摘要
Abstract
Objective To explore the key management points and effect of microsurgical treatment of parasagittal and falcine meningiomas.Methods The clinical data of 46 consecutive patients with parasagittal and falcine meningiomas admitted in Department of Neurosurgery,Affiliated Hospital of Shandong Academy of Medical Sciences from January 2008 to May 2015,were analyzed retrospectively.The tumors located in the anterior 1/3 segment of sagittal sinus and cerebral falx in 13 cases,in the central 1/3 segment in 29 cases,and in posterior 1/3 segment in 4 cases.The tumors originated from the sagittal sinus in 16 cases,originated from the cerebral falx in 22 cases,and involved with both the sagittal sinus and cerebral falx in 8 cases.Microsurgical treatment was performed in all the patients.Results In terms of Simpson grade of meningioma resection,32 cases received Simpson grade Ⅰ resection of the meningiomas,9 received grade Ⅱ,4 received grade Ⅲ,and 1 received grade Ⅳ.Classified by pathological typing of the meningioma,20 cases had meningothelial meningioma,12 had fibrous meningioma,6 had psammomatous meningioma,4 had angiomatous meningioma,2 had mixed meningioma,and 2 had atypical meningioma.With review to the treatment outcome,no patient died due to operation;myodynamia decrease occurred in 16 cases preoperatively,after surgery,myodynamia was improved in 14 cases,but unchanged in 1 case,and hemiplegia aggravated in 1 case;1-8 year longitudinal follow-up given to 41 cases showed that,seizure stopped after the surgery in 6 of 9 cases with epilepsy,tumors recurred in 3 cases,radiotherapy was performed in 2 cases,and 1 underwent the surgery again.Conclusion The important factors for enhancing the effect of microsurgery for parasagittal and falcine meningiomas are the following:accurate preoperative imaging diagnosis,proper surgical approach design and intraoperative strategies,well control of bleeding,and careful and meticulous protection and management of the sagittal sinus,draining veins and functional areas of the cerebral cortex.关键词
脑膜瘤/矢状窦/大脑镰/显微外科手术/治疗结果Key words
Meningioma/Sagittal sinus/Cerebral falx/Microsurgery/Treatment outcome分类
医药卫生
