论文部分内容阅读
目的总结大脑镰矢状窦部大型脑膜瘤的显微手术经验。方法回顾性分析67例大脑镰矢状窦大型脑膜瘤的临床资料。肿瘤起源于矢状窦26例,大脑镰30例,同时累及矢状窦和大脑镰11例。肿瘤主体位于镰窦前1/3段15例,中1/3段41例,后1/3段11例。瘤体大小为3cm×3cm×4cm～11cm×8cm×7cm。采用显微手术切除肿瘤,同时处理受累矢状窦和大脑镰。结果肿瘤全切除66例,其中SimpsonⅠ级19例,Ⅱ级47例;大部切除1例。无死亡病例。术后发生静脉性脑梗死和严重脑水肿4例,其余病人神经功能不同程度改善。随访6个月～9年,肿瘤复发4例(6.0%)。结论全切肿瘤和有效处理受累矢状窦和大脑镰是防止肿瘤复发的重要手段。在术中保护主要引流静脉是防止术后静脉性脑梗死和严重脑水肿肿胀的关键措施。
Objective To summarize the microsurgical experience of large meningiomas of the sagittal sinus of the cerebral falx. Methods A retrospective analysis of 67 cases of cerebellum sagittal sinus meningioma clinical data. Tumor originated in 26 cases of sagittal sinus, cerebellar sickle in 30 cases, involving both the sagittal sinus and falx in 11 cases. Tumor main body located in the first 1/3 sickle section 15 cases, 1/3 in 41 cases, 1/3 in 11 cases. The tumor size is 3cm × 3cm × 4cm ~ 11cm × 8cm × 7cm. Microsurgery was used to remove the tumor while treating the affected sagittal sinus and falx. Results Total resection of tumor in 66 cases, including Simpson Ⅰ 19 cases, Ⅱ 47 cases; the majority of resection in 1 case. No deaths. Four cases of venous cerebral infarction and severe cerebral edema occurred after operation, and the neurological function of the remaining patients improved to some extent. Follow-up 6 months to 9 years, 4 cases of tumor recurrence (6.0%). Conclusion Tumor resection and effective treatment of affected sagittal sinus and falx are important means to prevent tumor recurrence. Protecting the main drainage vein during operation is the key measure to prevent postoperative venous cerebral infarction and swelling of severe cerebral edema.