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报告上斜坡脑膜瘤25例的手术结果。男7例、女18例。年龄22～65岁,平均39.8岁。肿瘤大4～7.5cm,按其生长范围分为两类:一类向左、右两侧的生长范围基本相等,称斜坡型;另一类主体在斜坡,向一侧生长的范围大于对侧,称岩斜型;它们分别见10与15例。全数中内皮型见21例。临床症状:Ⅲ～Ⅻ颅神经麻痹19例;共济失调8例;肢体瘫痪锥体束征12例;颅压增高12例;昏迷2例;智能低下2例;卧床不起9例。椎动脉造影15例,见 BA、PCA、SCA 等动脉与前中央静脉移位.CT 扫描均见典型脑膜瘤影象.手术采用颞枕-枕下开颅,切开小脑幕、4例将横窦切断以利显露.2例将肿瘤连同粘着的硬脑膜切除(均为岩斜型);11例仅切除肿瘤,未切除脑膜(岩斜型4例);10例残留小片肿瘤(1.5×0.5×0.5cm)粘着于大动脉或脑干(岩斜型6例);2例残留瘤块直径大于2cm、术后近期疗效是:1例全无症状;3例仅Ⅲ及(或)Ⅴ麻痹;11例有多个颅神经麻痹;3例不全偏瘫;4例卧床不起;1例昏迷;2例死亡(死亡率8.0%)。随访11例(1.5～6年):2例做原工作;1例改换工作;4例生活自理;1例卧床不起;3例死亡.本文还就手术方法等进行了讨论.
Report on the surgical results of 25 cases of meningioma on the slope. 7 males and 18 females. Aged 22 to 65 years old, with an average of 39.8 years old. The tumor is 4 ~ 7.5cm wide, and divided into two categories according to its growth range: one kind of leftward and rightward growth is almost equal in scope and is called slope type; the other kind of body grows more on the slope and on one side than the contralateral side , Said rock ramp type; they see 10 and 15 cases respectively. All cases of endothelial type seen in 21 cases. Clinical symptoms: Ⅲ ~ Ⅻ cranial nerve palsy in 19 cases; ataxia in 8 cases; limb paralysis pyramidal tract sign in 12 cases; increased intracranial pressure in 12 cases; coma in 2 cases; poor intelligence in 2 cases; bedridden in 9 cases. Vertebral artery angiography in 15 cases, see BA, PCA, SCA and other arteries and the anterior central venous displacement.CT scan showed typical meningioma images.Patients with temporal pillow - suboccipital craniotomy, open the cerebellum, 4 cases will be horizontal 2 cases of tumor with adhesive dural resection (all rock oblique type); 11 cases of tumor only, without removal of the meninges (petroclival in 4 cases); 10 cases of residual small tumor (1.5 × 0.5 × 0.5cm) adhered to the aorta or brainstem (petroclival type in 6 cases); 2 cases of residual tumor block diameter greater than 2cm, the short-term effect is: 1 case of asymptomatic; 3 cases only Ⅲ and / or Ⅴ paralysis; Eleven patients had multiple cranial nerve palsies; three had incomplete hemiplegia; four had bedridden; one coma; and two died (8.0% mortality). Follow-up 11 cases (1.5-6 years): 2 cases of original work, 1 case of change work, 4 cases of self-care, 1 case of bedridden, and 3 cases of death.This article also discussed the surgical methods and so on.