镰旁脑膜瘤显微手术策略

目的介绍镰旁脑膜瘤分型及据此采用的显微手术治疗方法。方法根据冠状位MRI成像将镰旁脑膜瘤分为3型,Ⅰ型,肿瘤位于大脑镰的一侧,大脑镰本身没有移位或肿瘤靠近上矢状窦;Ⅱ型,肿瘤位于大脑镰的一侧,大脑镰局部明显向对侧移位;Ⅲ型,肿瘤向大脑镰两侧生长,两侧等大或不等大。Ⅰ型采用同侧、Ⅱ型采用对侧、Ⅲ型采用瘤体较小侧或非优势半球侧纵裂入路显微手术切除肿瘤。结果显微手术治疗镰旁脑膜瘤20例,均全切除肿瘤,无严重并发症及手术死亡。结论根据肿瘤不同生长方式选择肿瘤同侧或对侧纵裂入路显微手术治疗镰旁脑膜瘤比较合理。

Microsurgical strategy for parafalcine meningioma

Objective The objective of this paper is to propose a classifying scheme and microsurgical strategy for parafalcine meningiomas. Methods Twenty patients with parafalcine meningiomas were treated microsurgically in our hospital. They were divided into 3 types according to coronal MR imaging: type I, tumors attached to either side of the falx without the falx shift, or tumor was near to the superior sagittal sinus, 12 cases; type II, tumors attached to either side of the falx with the falx shift to the opposite side obviously, 4 cases; type III, tumors involved both side of the falx, 4 cases. Results Tumor resection was classified by a modified Simpson grading, Grade 0 resection of meningioma was achieved in 8 cases, Grade I resection in 12. Intraoperative transfusions were performed in only 7 cases. There were no serious complications and operative death. Conclusion It seems reasonable to remove parafalcine meningiomas microsurgically through iso-or opposite interhemispheric approach of the tumor according to growing type by minimal craniotomy.