Department of Neurosurgery, The First Bethune Hospital of Jilin University, 71 Xinmin Avenue, Changchun 130021, China.
World J Surg Oncol. 2011 Jun 15;9:64. doi: 10.1186/1477-7819-9-64.
There are several treatment approaches for pineal region meningiomas, such as Poppen's approach, Krause's approach and combinations of the two approaches. We present our experience with the use of 3D-computed tomography angiography for planning the surgical removal of pineal region meningiomas using a suboccipital transtentorial approach (Poppen's approach) and evaluate the role of Poppen's approach.
During the period from January 2005 to June 2010, ten patients presented to us with pineal region meningioma. MRI was routinely used to define the tumor size, position, and its relevant complications while 3D-CTA was applied to define the blood supply of the tumor and the venous complex (VC) shift before operations. Most of the meningiomas had developed at both sides of the tentorial plane and extended laterally with typical characteristics of a pineal region tumor.
All tumors were completely removed surgically without any injury to the VC. Postoperative intracranial infection occurred in one case who recovered after antibiotics were given. Postoperative intraventricular hemorrhage and pneumocephalus were found in one case, but fully recovered after conservative treatment. In the nine cases of concurrent hydrocephalus, this was gradually relieved in eight patients and the single case that became aggravated was successfully treated with ventriculoperitoneal shunt. Moreover, the follow-up MRI examinations did not indicate any recurrence of the meningiomas.
We found that the use of Poppen's approach is strongly supported for the successful removal of pineal region meningiomas without serious complications.
松果体区脑膜瘤有几种治疗方法，如 Poppen 入路、Krause 入路以及两种方法的联合。我们介绍了使用三维计算机断层血管造影术（3D-CTA）来规划经枕下经天幕入路（Poppen 入路）切除松果体区脑膜瘤的经验，并评估了 Poppen 入路的作用。
2005 年 1 月至 2010 年 6 月期间，有 10 名患者因松果体区脑膜瘤就诊于我们医院。MRI 常规用于定义肿瘤的大小、位置及其相关并发症，而 3D-CTA 则用于在手术前定义肿瘤的供血和静脉复合体（VC）移位。大多数脑膜瘤位于天幕平面的两侧，并向外侧延伸，具有典型的松果体区肿瘤特征。
所有肿瘤均在不损伤 VC 的情况下完全切除。术后颅内感染 1 例，经抗生素治疗后痊愈。术后并发脑室出血和脑积气 1 例，经保守治疗后痊愈。9 例并发脑积水的患者中，8 例逐渐缓解，1 例加重患者成功行脑室-腹腔分流术。此外，术后 MRI 检查未发现脑膜瘤复发。
我们发现，Poppen 入路的使用强烈支持成功切除松果体区脑膜瘤，且无严重并发症。
