小脑幕脑膜瘤的显微手术治疗

目的：总结小脑幕脑膜瘤显微手术的经验和教训，以利提高手术的疗效。方法：采用经颞枕硬膜内入路，枕部经小脑幕与枕下联合入路，枕下内侧入路、旁正中入路，均采用显微神经外科技术切除肿瘤。结果：肿瘤全切除6例，次全切除2例，术后死亡1例，共济失调1例，构音障碍和饮水咳呛1例，5例痊愈。结论：小脑幕脑膜瘤切除应选择合适的手术入路。手术时必须切除窦内肿瘤，在切除肿瘤侵入的横窦前、必须有血管造影完全闭塞的证据。脑干随近的肿瘤先行包膜内切除，后切除肿瘤包膜。

Microsurgical treatment of tentorial meningioms

Objective: The microsurgical experience and insufficiency for tentorial meningioms were reviewed in order to heighten curative effect of microsurgical treatment. Methods: Tumors of all patients were removed by microsurgery and operated through subtemporal intradural approach?occipital transtentorial and suboccipital medical combined approach?suboccipital medical approach and paramiddle suboccipital approach respectively. Results: Total removal of the tumor was achieved in 6 patients and subtotal resection in 2 cases. Among them, 1 case died postoperatively, 1 case supervened ataxia, 1 case dysdipsia and 1 case dyslalia, 5 cases recovered. Conclusion: Suitable approach should be chosen on resecting tumor of different position. During the operation, the tumor must be resected in the lateral sinus. Before operation it is necessary to confirm that lateral sinus had been filled with tumor proved by cerebral angiography. At resecting tumor bordering on brain stem, one should first resect section in capsule then remove the capsule of tentorial meningioms.