枕大孔区脑膜瘤18例临床分析

Meningiomas of foramen magnum

对１８例枕大孔区脑膜瘤患者进行回顾性分析，其中６７％以枕颈部疼痛起病．枕颈部疼痛、渐进性四 肢感觉运动障碍和手内肌萎缩为其三主征，ＭＲ检查对本病诊断具有重要意义。１８例患者共进行２０次手术．１５ 例（次）经后颅窝正中切口．４例（次）经中线拐杖形切口．１例经口咽入路手术。肿瘤全切除１３例，大部切除５例。 术后死亡１例；随访１４例．１１例恢复正常工作。

patients with foramen magnum meningiomas were retrospectively studied. The pain in the neck and occipital region was the most common primary symptom. which occurred in 67%(12/18 ). The pain in the neck and occipital region,progressive motor and sense disturbance in the extremities and the atrophy in the intrin- sic muscles of hands were the 3 main sign. The tumor was easy missed by the CT examination. MR took an im- portant role in the correct diagnosis. 20 time operations were carried out in this 18 cases. 15 cases were operated by the standard midline suboccipial approach .4 cases were operated by the posterolateral approach,and 1 case by the transoral-trnaspharyngeal approach. l3 tumors were total removed (Simpson Ⅰ～Ⅱ ). 5 tumors were subtotal resection (Simpson Ⅲ～Ⅳ). One was died of intracranial infection caused by CSF leakage after operation in the transoral-trnaspharyngeal approach patient, l4 cases have been follwed up for 1.5～25 years, 11 cases have got good recovery.