手术治疗包裹大动脉的颅底中央区脑膜瘤

Surgical Treatment of Large Meningiomas Encasing Cerebral Arteries at Central Skull Base

目的 探讨对包裹重要脑动脉的颅底中央区脑膜瘤的手术方法。方法 回顾性分析经颧弓入路手术治疗 9例颅底中央区巨大脑膜瘤的临床资料 ,肿瘤位于前床突、鞍结节、鞍隔、海绵窦区、岩骨尖及斜坡等广泛区域并完全包裹 1支以上的脑动脉。结果 6例脑膜瘤获得了全切除 ,3例脑膜瘤获得次全切除 ,1例的精神症状及记忆力减退症状加重 ,2例出现动眼神经麻痹 ,无手术死亡 ;随访 12月至 8年 ,1例术后 4 1月肿瘤复发。结论 神经影像学技术的进步和显微外科技术应用 ,大多数颅底中央区包裹重要脑动脉的巨大脑膜瘤可以获得成功的手术切除。

Objective To explore the surgical treatment of large meningiomas encasing cerebral arteries in the extensive area of the central skull base.Methods Consecutive clinical data of 9 patients with large meningiomas in anterior clinoidal processes, tuberculum sellae,diaphragm sella,cavernous sinus,petrous apex and clivus encasing at least one cerebral artery.were analized.Results The meningiomas were completelly resected in 6 patients,and subtotally resected in 3.There was no death. The follow-up period ranging from 12 months to 8 years and tumor recurrence occurred in 1 case after 41 months postoperatively.Conclusion Advances in microsurgical techniques and neuroradiological image have radically improved the outcome so that today the central skull base meningiomas encasing large cerebral arteries can be successfully removed in the majority of the patients.