角回后方皮层入路显微手术切除侧脑室三角区脑膜瘤

Microsurgery through transcortical approach behind the angular gyrus for lateral ventricle trigone meningiomas

目的探讨侧脑室三角区脑膜瘤的临床特点、诊断以及显微手术治疗方法。方法回顾性分析2013年9月至2015年12月经角回后方皮层入路显微手术治疗的22例侧脑室三角区脑膜瘤的临床资料。结果 22例肿瘤全切除,无手术死亡病例,术后患者头痛头晕、恶心呕吐症状均明显改善。术后发生命名性失语1例,给予降颅内压治疗后有所改善;出现对侧肢体肌力稍减弱伴有酸麻感1例,出院时恢复良好。术后病理类型:纤维型11例,上皮型3例,混合型1例,血管型1例,具体类型不明确6例。结论角回后方皮层入路是手术切除侧脑室三角区脑膜瘤较好的入路;术中对供瘤血管的处理及对重要结构的保护是避免术后并发症的关键。

Objective To investigate the clinical characteristics ,diagnosis and microsurgical treatment of the meningiomas in the trigones of lateral ventricles in order to improve the level of their diagnosis and treatment. Method The clinical data of 22 patients with meningiomas in the trigones of lateral ventricles, who were treated by microsurgery through transcortical approach behind the angular gyrus in our hospital from September, 2013 to December, 2015, were retrospectively analyzed. Results The total resection of the tumors was achieved in all the patients. No patients died of the surgery. The clinical symptoms and signs were significantly improved in all the patients after the operation. Conclusions The transcortical approach behind the angular gyrus is a good approach of microsurgery for the meningiomas in the trigones of lateral ventricles. The suitable treatment of tumors blood vessels and the protection of important structure are the keys to avoiding postoperative complications.