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影响脑膜瘤切除术后脑静脉梗死的危险因素。

Risk factors influencing cerebral venous infarction after meningioma resection.

机构信息

Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, People's Republic of China.

出版信息

BMC Neurol. 2022 Jul 13;22(1):259. doi: 10.1186/s12883-022-02783-2.

Abstract

BACKGROUND

Cerebral venous infarction (CVI) is a serious complication after meningioma resection. The risk factors of postoperative cerebral venous infarction after surgical resection of meningioma can be determined through large samples and this study can add evidence to the literature.

METHODS

The clinical and imaging data of 1127 patients with intracranial meningiomas who underwent resection in our hospital were retrospectively collected and analyzed. CVI was evaluated by postoperative imaging and clinical manifestations. Univariate and multivariate analyses were performed to identify risk factors associated with CVI.

RESULTS

Overall, 4.7% (53/1127) of patients experienced CVI after meningioma resection. Multivariate analysis revealed superficial meningioma, moderate to severe peritumoral edema, peritumoral critical vein and WHO grade II-III as independent predictors of a postoperative CVI. After timely intervention, the symptoms were clearly alleviated in one month, and the prognosis was good, but injury to key veins could cause irreversible neurological disorders.

CONCLUSIONS

Intraoperative protection of veins is the primary way to prevent CVI. The present study identified several significant and independent risk factors for postoperative venous infarction, thereby enabling the identification of high-risk patients who require special attention during clinical and surgical management.

摘要

背景

脑静脉梗死(CVI)是脑膜瘤切除术后的一种严重并发症。通过大样本可以确定脑膜瘤切除术后发生脑静脉梗死的术后危险因素,本研究可为文献提供证据。

方法

回顾性收集我院 1127 例颅内脑膜瘤切除术患者的临床及影像学资料,术后影像学及临床表现评估 CVI。采用单因素及多因素分析确定与 CVI 相关的危险因素。

结果

脑膜瘤切除术后,总体有 4.7%(53/1127)的患者发生 CVI。多因素分析显示,表浅脑膜瘤、中重度瘤周水肿、瘤周关键静脉和 WHO 分级 II-III 是术后 CVI 的独立预测因素。经及时干预,一个月内症状明显缓解,预后良好,但关键静脉损伤可导致不可逆的神经功能障碍。

结论

术中保护静脉是预防 CVI 的主要方法。本研究确定了几个与术后静脉梗死显著相关的独立危险因素,从而能够识别出在临床和手术管理中需要特别关注的高危患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e358/9277820/028c5db437f2/12883_2022_2783_Fig1_HTML.jpg

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