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猫颅后窝脑膜瘤伴孔疝的手术治疗。

Surgical treatment of rostrotentorial meningioma complicated by foraminal herniation in the cat.

机构信息

Veterinary Medical Teaching Hospital, Nippon Veterinary and Life Science University, Musashino, Tokyo, Japan.

出版信息

J Feline Med Surg. 2020 Dec;22(12):1230-1237. doi: 10.1177/1098612X20924314. Epub 2020 Jun 1.

Abstract

OBJECTIVES

This study was performed to evaluate retrospectively the clinical signs, complications and postoperative outcomes of feline intracranial meningioma (IM) with concurrent cingulate, transtentorial and foramen magnum herniations.

METHODS

The medical records and MRI scans of cats with IM and cerebral herniation were reviewed. Cases involving concurrent cingulate, transtentorial and foramen magnum herniations were included. Owners were contacted to obtain long-term follow-up information.

RESULTS

Seven cats (four castrated males and three spayed females) met the inclusion criteria. Median age was 13.0 years (range 9.9-16.1 years) and median duration of clinical signs was 35 days (range 21-163 days). The clinical signs of cats with cerebral herniation included visual impairment (n = 5 [71.4%]), ataxia (n = 4 [57.1%]), impaired consciousness (n = 2 [28.6%]), head pressing (n = 2 [28.6%]), paresis (n = 1 [14.3%]), torticollis (n = 1 [14.3%]) and personality changes (n = 1 [14.3%]). Median tumour volume, cranial cavity volume and tumour volume:intracranial volume ratio before surgery were 3.37 cm (range 3.23-11.5 cm), 32.6 cm (range 29.8-78.3 cm) and 10.4% (range 5.3-35.3%), respectively. Median overall tumour excision rate was 90.6%. Preoperative intracranial pressure (ICP) ranged from 15 to 32 mmHg (median 29 mmHg). In all cases, the ICP dropped to 0 mmHg immediately after tumour removal. No adjuvant therapy was required after surgery. The median survival period was 612 days (range 55-1453 days).

CONCLUSIONS AND RELEVANCE

The results of this study indicate that surgical treatment of rostrotentorial IM is effective and allows prolonged survival, even in cats with concurrent cingulate, transtentorial and foramen magnum herniations.

摘要

目的

本研究旨在回顾性评估伴有扣带回、颅后窝和枕骨大孔疝的猫颅内脑膜瘤(IM)的临床体征、并发症和术后结果。

方法

回顾性分析伴有 IM 和大脑疝的猫的病历和 MRI 扫描。纳入同时伴有扣带回、颅后窝和枕骨大孔疝的病例。联系主人以获取长期随访信息。

结果

7 只猫(4 只去势雄性和 3 只去势雌性)符合纳入标准。中位年龄为 13.0 岁(范围 9.9-16.1 岁),中位临床症状持续时间为 35 天(范围 21-163 天)。伴有大脑疝的猫的临床体征包括视力障碍(n=5 [71.4%])、共济失调(n=4 [57.1%])、意识障碍(n=2 [28.6%])、头部按压(n=2 [28.6%])、瘫痪(n=1 [14.3%])、斜颈(n=1 [14.3%])和性格改变(n=1 [14.3%])。手术前肿瘤体积、颅腔体积和肿瘤体积/颅内体积比中位数分别为 3.37 cm(范围 3.23-11.5 cm)、32.6 cm(范围 29.8-78.3 cm)和 10.4%(范围 5.3-35.3%)。肿瘤总体切除率中位数为 90.6%。术前颅内压(ICP)范围为 15-32 mmHg(中位数 29 mmHg)。所有病例肿瘤切除后 ICP 立即降至 0 mmHg。术后无需辅助治疗。中位生存时间为 612 天(范围 55-1453 天)。

结论和相关性

本研究结果表明,颅后窝 IM 的手术治疗是有效的,即使伴有扣带回、颅后窝和枕骨大孔疝的猫也能获得长期生存。

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