Tzekov Chr, Spiriev T, Cherninkova S, Bussarsky V, Laleva L, Cekov A, Naydenov E, Minkin K, Marinov M, Romansky K
Khirurgiia (Sofiia). 2010(2-3):19-23.
Meningiomas are the most common slow growing tumors of the central nervous system which arise from the arachnoid cells. One certain group of them--tuberculum sellae (TS), cavernous sinus (CS), anterior clinoid (AC), and planum sphenoidale (PS) meningiomas, a group often called "parasellar", present with monocular or binocular visual deterioration, which is often unrecognized by patients until visual loss is severe and the tumor has reached a significant size.
To describes the type of visual deficit, severity of the symptoms and surgical treatment of tumors with the above mentioned localization.
During the period 2003-2007 year, 93 patients (31 man, 62 women) diagnosed with meningiomas of the TS (31 cases), CS (16 cases), AC (21 cases), PS (17 cases), (see text) - 8, were diagnosed and operated on in the Department of Neurosurgery, University Hospital "St. Ivan Rilsky", Sofia, Bulgaria. Retrospective analysis was done.
Age at diagnosis ranged from 12 to 74 years, but the majority of cases were in the 5th and 6th decade of life. Localization of was: TS 33%, CS 17%, AC 24%, PS 18% and with more than one area affected in 8 %. The most common symptom was slowly progressing loss of monocular visual acuity (81% of cases). 68% of patients presented with already severely deteriorated vision (0.1-0). Neuro-ophthalmological examination (see text) the patients. Computed tomography and magnetic resonance imaging were the main diagnostic methods. "Gross" total resection was achieved in 62%, subtotal in 12%, partial in 26% of the cases. There was early improvement in 57% of the patients. Death due to cardio-respiratory insufficiency occurred in one case.
the progressive monocular visual deficit is often the first clinical symptom of the parasellar menigiomas. The early diagnosis is important for the success of surgery. Close collaboration between different specialists (ophthalmologists, neurologist and neurosurgeons) is essential for treatment of these tumors and prevention of the visual deterioration.
脑膜瘤是起源于蛛网膜细胞的中枢神经系统最常见的生长缓慢的肿瘤。其中特定的一组——鞍结节（TS）、海绵窦（CS）、前床突（AC）和平蝶骨平面（PS）脑膜瘤，这一组常被称为“鞍旁”脑膜瘤，表现为单眼或双眼视力减退，在视力严重丧失且肿瘤已达到相当大的大小时，患者往往才意识到，而此前常未被察觉。
描述上述部位肿瘤的视力缺损类型、症状严重程度及手术治疗方法。
2003年至2007年期间，93例患者（31例男性，62例女性）被诊断为鞍结节（31例）、海绵窦（16例）、前床突（21例）、平蝶骨平面（17例）、（见正文）-8例脑膜瘤，在保加利亚索非亚“圣伊万·里尔茨基”大学医院神经外科被诊断并接受手术。进行了回顾性分析。
诊断时年龄在12岁至74岁之间，但大多数病例处于50岁和60岁年龄段。肿瘤部位分布为：鞍结节33%，海绵窦17%，前床突24%，平蝶骨平面18%，超过一个区域受累的占8%。最常见的症状是单眼视力逐渐丧失（81%的病例）。68%的患者视力已严重减退（0.1-0）。对患者进行了神经眼科检查（见正文）。计算机断层扫描和磁共振成像为主要诊断方法。62%的病例实现了“大体”全切，12%为次全切除，26%为部分切除。57%的患者术后早期病情改善。1例患者因心肺功能不全死亡。
进行性单眼视力缺损往往是鞍旁脑膜瘤的首个临床症状。早期诊断对手术成功很重要。不同专科医生（眼科医生、神经科医生和神经外科医生）密切合作对于治疗这些肿瘤及预防视力减退至关重要。
