Microsurgical treatment for meningiomas of falcotentorinal junction
10.3760/cma.j.issn.1671-8925.2016.10.008
- VernacularTitle:显微手术切除镰幕交界区脑膜瘤的临床分析
- Author:
Wenzhong MEI
1
;
Honghai YOU
;
Jianwu CHEN
;
Xiyue WU
;
Dezhi KANG
Author Information
1. 福建医科大学附属第一医院神经外科
- Keywords:
Falcotentorinal meningioma;
Operative approach;
Microsurgery;
Imaging
- From:
Chinese Journal of Neuromedicine
2016;15(10):1016-1020
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features,differential diagnosis,preoperative imaging and microsurgical treatment skills/experiences of falcotentorinal meningiomas.Methods Nine patients with falcotentorinal meningiomas,admitted to and performed microsurgical resection in our hospital from January 2009 to October 2015,were chosen in our study.Preoperative examinations included MR imaging and CT angiography:the Galen's veins were totally occluded in two patients and stenosed of different degrees in 7 patients;3 patients had meningiomas at the above of Galen's veins,and 6 under the Galen's veins.Seven patients were resected via Poppen approachs,and 2 with considerable lateral extensions tumors were via bilateral Poppen approach.Results Simpson Grade Ⅰ-Ⅱ tumor resection was achieved in 7 patients and Grade Ⅲ in two patients.Postoperative complications included cortical blindness in two patients recovering within 3 months of follow-up,intracranial infection in one patient curing two weeks later;no postoperative death or severe disabilities were noted.Clinical follow-up was available in 9 patients for a period ranging from 0.5 to 7 years:7 patients enjoyed Simpson Grade Ⅰ-Ⅱ resection had no tumor recurrence and were self-reliable;in two patients with Simpson Grade Ⅲ resection,one accepted postoperative treatment of Gamma knife,another one without other treatment,and these two patients had no tumor progression in the 28 months of follow-up.Conclusion The microsurgery is preferred in the resection of falcotentorinal meningiomas,and sufficient preoperative imaging evaluation,reasonable operation concept,technique and experience of adept micromanipulation are the keys to the safe and effective removal of the tumors.
