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.

Objective:To analyze the clinical, imaging and pathological characteristics of pleomorphic xanthoastrocytoma (PXA), and to explore the effective treatment of PXA.Methods:A total of 25 patients with PXA admitted to our hospital from July 1, 2012 to December 1, 2019 were chosen in our study. Their clinical manifestations, imageology features, pathology features, treatments, and prognoses were retrospectively analyzed.Results:Headache ( n=12) and epilepsy ( n=8) were the most common first symptoms in 25 patients. The tumors in 8 patients were located in the parietal lobe, 6 were in the temporal lobe, and 6 were in the frontal lobe. Among the pathological results, the average positive rate of cell proliferation antigen Ki-67 and P53 in patients with WHO grading II was 6.4% and 21.2%, respectively; the average positive rate of Ki-67 and P53 in patients with WHO grading III was 22.2% and 48.3%, respectively. Synaptophysin protein was confirmed in 12 of the 15 patients. Twenty patients were followed up for 31 months after surgery; 19 survived; 9 had no tumor recurrence or residue, including 8 with WHO grading II and one with WHO grading III. Conclusion:Pathological result play an important role in PXA diagnosis; the prognosis of patients with WHO grading II is obviously better than that of patients with WHO grading III.