侧脑室三角区脑膜瘤的显微手术治疗

Microsurgery for lateral ventricular meningiomas(report of 28 cases)

目的探讨侧脑室三角区脑膜瘤的临床特点、显微手术方法及其临床效果。方法 2005年12月至2012年12月收治28例侧脑室三角区脑膜瘤患者,全部在全麻下行开颅显微手术治疗,其中顶枕入路18例,颞中回入路7例,经胼胝体后部入路3例。结果 28例患者中,肿瘤全切25例,次全切3例。所有患者均获得随访,随访时间为3个月至7年,24例恢复良好,3例复发后给予再次手术切除;1例患者术后1年复查示脑积水,行脑室-腹腔分流术。结论侧脑室三角区脑膜瘤临床表现以慢性颅内压增高为主,可伴有局灶性神经功能缺损。头部CT及MRI是其诊断最可靠的方法。根据患者的具体情况,选择合适的手术入路显微手术治疗,配合术中B超,可获得满意的治疗效果。

Objective To investigate the clinical features and treatment of lateral ventricle meningiomas（LVM）. Methods The clinical data of 28 patients with LVM were analyzed retrospectively, including the clinical manifestations, imaging features, surgical way and curative effect. Results Of 28 patients with LVM undergoing microsurgery, 25 received total removal of LVM and 3 subtotal. The following up from 3months to 7 years showed that of 28 patients, 24 were recovered very well 3 had a relapse of LVM and underwent total resection of the tumors again, and 1 had hydrocephalus 1 year after the operation and received ventricloperitoneal shunt. Conclusions The clinical manifestations include chronic intracranial hypertension and focal neurological dysfunction in the most patients with LVM. CT and MRI are the best methods to make the diagnosis of LVM. The therapeutic effect of microsurgery via appropriate approach selected according to patients＂ specific conditions on LVM is good. The intraoperative ultrasound is helpful to improving the therapeutic effects of the surgery in the patients with LVM.