侧脑室脑膜瘤的诊断及显微手术治疗

目的 探讨侧脑室内脑膜瘤诊断特点及显微手术方法.方法 MRI和/或CT确诊并行显微手术切除侧脑室脑膜瘤24例,其中2例内窥镜辅助切除.肿瘤位于左侧三角区13例,右侧三角区7例,右侧体部1例,横跨双侧三角区1例,左侧颞角2例.顶枕入路15例,颞中回入路7例,经胼胝体后部入路2例.结果 24例影像学诊断与术后病理相符合,均给予全切.完整切除5例,分块切除19例.18例获得随访,完全正常10例,3例复发再次手术全切,癫痫2例,同向性偏盲3例.结论 CT和MRI是诊断侧脑室脑膜瘤的最可靠的手段,显微手术是目前侧脑室脑膜瘤的首选治疗方法.

Diagnosis and microsurgical operation for lateral intraventricular meingiomas

Objective To explore diagnosis feature of the lateral intraventricular meningiomas and microsurgical approaches for removing it. Method There were 24 patients with 24 tumors,of which, 13 tumors on the left trigon,7 tumors on the right trigon,1 tumor on the right body,and 1 tumor strideon both lateral trigons and 2 tumors on the left temporal horn. All the 24 cases were diagnosed by MRI and/or CT and removed by microsurgical operation ,of which, 2 cases by neuroendoscopy-assisted microsurgical operation, 15 cases by paramedian parieto-occipital approach, 7 cases by middle temporal gyrus approach and 2 cases by transcallosal approach. Results All the 24 cases were diagnosed in coincidence between imaging and pathology and removed totally,of which,5 cases were removed wholly, 19 cases were removed by piecemeal. 18 cases were followed-up, 10 cases were normal, 3 cases were relapsed and removed totally again, 2 cases and had 3 cases epilepsy,and had homonymous hemianopia. Conclusion CT and MRI are the most reliable diagnosis measure and microsurgical operation is the best treatment method for lateral intraventricular meningiomas.