儿童颅内脑膜瘤19例报告

目的 分析总结儿童颅内脑膜瘤的临床特点及治疗效果。方法 经手术和病理证实15岁以下儿童脑膜瘤19例，其中男9例，女10例。年龄6－15岁，平均10.9岁。临床表现以颅内压增高（11例）、颅神经麻痹（7例）和癫痫（6例）为主。CT和MRI检查发现肿瘤钙化4例，占21.5%(4/19)，囊变3例16.5%(3/19)，出血1例5.2%(1/19)。肿瘤位于大脑凸面4例，侧脑室3例，岩斜区3例，侧裂2例，鞍区2例，中颅窝底2例，矢状窦旁、大脑镰及枕大孔各1例。术中见肿瘤与硬脑膜明显粘连5例，贴近硬脑膜但无明显粘连9例，2例侧裂脑膜瘤与硬脑膜完全无关，侧脑室3例起源于脉络丛组织。病理报告纤维型脑膜瘤8例，内皮型脑膜瘤5例，砂粒型脑膜瘤2例，混合型脑膜瘤1例，非典型脑膜瘤1例，未分类2例。结果 肿瘤全切除15例，不全切除4例，无手术死亡。随访9例（6个月－4年），能正常参加学习和劳动者5例，有癫痫发作2例，肿瘤复发2例。结论 儿童颅内脑膜瘤的发病率无女性优势，肿瘤的发生部位与成人不同，肿瘤与硬脑膜关系不密切。手术全切除肿瘤是治疗的关键。

Intracranial meningiomas in children:a report of 19 cases

Objective To study the clinical features and treatment results of childhood meningioma.Methods Nineteen cases (male 9,female 10) under 15 years of age with meningiomas confirmed by operation and pathology were reported.The tumors were located in the convexity (4),lateral ventricle (3),petrous portion (3),Sylvian fissure (2), sellar region (2),the middle cranial fossa (2),the parasagittal (1),cerebral falx (1),and foramen occipital magnum (1).Results Fifteen patients underwent complete resection whereas 4 had incomplete resection.There was no operative mortality.Nine children were followed up (6 months to 4 years),2 children had recurrence of tumors.Conclusions Meningioma is rare in children.Girls are not affected more often than boys.Tumor locations that are rare in adults are more common in children.Absence of dural attachment is more common in children than in adults. Whenever feasible every effort should be made to achieve total resection of the tumor during the first operation.