Clinical analysis of surgical treatment in meningiomas located in middle 1/3 superior saggital sinus with nearly total occlusion
AIM: To analyze the surgical treatment of meningiomas located in the middle 1/3 superior saggital sinus (SSS) with nearly total occlusion and to discuss the strategy of preventing postoperative complications. METHODS: The clinical data of 10 patients with meningiomas located in the middle 1/3 SSS with nearly total occlusion were analyzed retrospectively. All the patients underwent preoperative CT angiography (CTA)/MR venography (MRV) or digital subtraction angiography (DSA) examination. Tumors were resected by microsurgery and the sagittal sinus and falx were properly managed intraoperatively. Routine treatment was given after surgical resection. RESULTS: Six cases achieved Simpson grade Ⅰ resection and 4 cases achieved Simpson grade Ⅱ resection. Eight patients awoke postoperatively within 24 h. Consciousness disorder occurred in 3 of the 8 patients on the 2 nd day and CT scan revealed acute epidural hematoma in non-operative location. Two cases were in persistent coma and CT scan revealed acute diffuse brain swelling. Epidural hematoma was removed by a second microsurgery and the patients recovered well. Bain swelling was treated with dehydration strategy and patients awoke. No tumors recurrence was found during the follow-up averaging 21.5 months. CONCLUSION: Careful analysis of the imaging data preoperatively, resection of tumors by microsurgical techniques and proper intraoperative management of central sulcus vein and superior saggital sinus are of vital importance for the improvement of the prognosis and the prevention of postoperation complications in patients with meningiomas located in the middle 1/3 SSS with nearly total occlusion.
NETL
NSTL
万方数据
维普
