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巨大嗅沟脑膜瘤:经双额显微手术入路后的眼科和认知结果

Giant olfactory groove meningioma: ophthalmological and cognitive outcome after bifrontal microsurgical approach.

作者信息

Gazzeri Roberto, Galarza Marcelo, Gazzeri Giovanni

机构信息

Department of Neurosurgery, San Giovanni Addolorata Hospital, Via O. Tommasini 13, 00162, Rome, Italy.

出版信息

Acta Neurochir (Wien). 2008 Nov;150(11):1117-25; discussion 1126. doi: 10.1007/s00701-008-0142-z. Epub 2008 Oct 21.

DOI:10.1007/s00701-008-0142-z
PMID:18936875
Abstract

OBJECT

Olfactory groove meningiomas arise in the midline along the dura of the cribriform plate and may reach a large size before producing symptoms. We conducted a retrospective study of patients with these lesions focused on pre- and post-operative investigations for ophthalmological, personality and cognitive disturbances.

METHODS

The authors reviewed 36 patients with giant olfactory groove meningiomas surgically treated via a bifrontal approach. Ophthalmological evaluation included visual acuity, fundoscopy and visual fields while psychological evaluation included a Mini-Mental State Examination. Data was collected before, 1 and 12 months after surgery. Formal pre- and post-operative ophthalmological examinations discovered visual deficits in 55.5% of the patients. Within the first month after surgery, improvement of visual acuity and of visual field deficits was observed. In post-operative neuropsychological testing, higher mental functions showed improvement. The most frequent post-operative complication was persistent rhinorrhoea in two patients.

CONCLUSIONS

Results at longest follow up indicate that cognitive changes and visual deficits will improve in patients with giant olfactory groove meningiomas after a bifrontal approach, without additional neurological deficits.

摘要

目的

嗅沟脑膜瘤起源于沿筛板硬脑膜的中线部位,在出现症状之前可能长得很大。我们对患有这些病变的患者进行了一项回顾性研究,重点关注术前和术后对眼科、人格及认知障碍的检查。

方法

作者回顾了36例经双额入路手术治疗的巨大嗅沟脑膜瘤患者。眼科评估包括视力、眼底检查和视野检查,而心理评估包括简易精神状态检查。在手术前、术后1个月和12个月收集数据。术前和术后的正式眼科检查发现55.5%的患者存在视力缺陷。在术后第一个月内,观察到视力和视野缺陷有所改善。在术后神经心理学测试中,高级心理功能有所改善。最常见的术后并发症是两名患者出现持续性鼻漏。

结论

最长随访结果表明,采用双额入路治疗巨大嗅沟脑膜瘤的患者,认知变化和视力缺陷将得到改善,且无额外的神经功能缺损。

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