大型矢状窦旁脑膜瘤显微外科治疗

Microsurgical treatment of large parasagittal meningiomas

目的：探讨显微外科技术在大型矢状窦旁脑膜瘤手术中的应用。方法肿瘤位于矢状窦前1/3有6例，中1/3有13例，后1/3有8例；其中跨上矢状窦两侧的有2例，颅骨侵犯的2例，软组织侵犯的1例合并有肿瘤卒中。采用跨中线骨瓣，显微手术技术切除27例上矢状窦旁大型脑膜瘤。结果肿瘤SimpsonⅠ级16例，SimpsonⅡ级8例，SimpsonⅢ级3例；术后回访3-36个月，1例术后二个月复发。结论采用显微外科技术，暴露上矢状窦，充分显露肿瘤，有效控制出血，保护回流静脉，可减少并发症。

Objective To investigate the application of microsurgical techniques in the operation of bilateral large parasagittal meningiomas .Methods The tumors located in the anterior third sagittal sinus was 6 cases, the middle third 13, the posterior third 8,which cross the superior sagittal sinus on both sides of the 2 cases, 2 skull invasion, invasion of soft tissues of one with tumor apoplexy .27 patients with large meningiomas in the superior parasagittal sinus were treated with a series of microsurgical techniques .Results SimpsonⅠgrade removal was detected in 16 patients,SimpsonⅡgrade in 8 and SimpsonⅢgrade in 3.The follow-up period of patients ranged from 3 to 36 months, and tumor recurrence was observed in 1 case after 2 months.Conclusions The application of microsurgery could fully disclose superior parasagittal sinus and tumor effectively through interhemispheric approach , control hemorrhage and protect refluxing vein ,reduce complications .