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硬脑膜内型脑膜瘤的手术治疗效果。

Surgical outcome of sinodural meningiomas.

机构信息

National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.

National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru 560029, Karnataka, India.

出版信息

J Clin Neurosci. 2024 Oct;128:110804. doi: 10.1016/j.jocn.2024.110804. Epub 2024 Aug 20.

Abstract

INTRODUCTION

Meningiomas located in the posterior fossa and involving the sinodural angle at the junction of the transverse and sigmoid sinuses are uncommon and present unique challenges due to their complex anatomical location. Despite their distinctive features, they are frequently categorized with tentorial meningiomas in the literature.

MATERIALS AND METHODS

This retrospective study conducted at a tertiary care center involved 64 patients with sinodural meningiomas who underwent surgical treatment between 2010 and 2023. The analysis covered demographics, clinical presentation, radiological characteristics, surgical approaches, histopathological findings, and outcomes.

RESULTS

The cohort predominantly comprised females (83 %) with a mean age of 47.64 years. Headache (92.2 %) and gait disturbances (62.5 %) were the most common presenting symptoms. Preoperative imaging showed sinus involvement in 57.8 % of cases, predominating Sindou's type 1 and type 6. Gross total resection (Simpson grades 1-2) was achieved in 40.6 % of cases. Postoperative complications included pseudomeningocele (9.4 %), especially in patients with hydrocephalus.

CONCLUSION

Sinodural meningiomas represent a distinct subset of posterior fossa tumors, necessitating meticulous preoperative planning and intraoperative decision-making regarding sinus management. The study underscores the importance of individualized surgical strategies and highlights the role of radiosurgery in managing residual disease effectively.

摘要

简介

位于颅后窝并累及横窦和乙状窦交界处的窦脊脑膜瘤较为少见,由于其复杂的解剖位置,存在独特的挑战。尽管它们具有独特的特征,但在文献中常与天幕脑膜瘤归为一类。

材料与方法

这项在三级医疗中心进行的回顾性研究纳入了 2010 年至 2023 年间接受手术治疗的 64 例窦脊脑膜瘤患者。分析涵盖了人口统计学、临床表现、影像学特征、手术入路、组织病理学发现和结果。

结果

该队列主要由女性(83%)组成,平均年龄为 47.64 岁。头痛(92.2%)和步态障碍(62.5%)是最常见的首发症状。术前影像学显示 57.8%的病例存在窦受累,以 Sindou 1 型和 6 型为主。40.6%的病例实现了大体全切除(Simpson 分级 1-2)。术后并发症包括假性脑膨出(9.4%),尤其是在脑积水患者中更为常见。

结论

窦脊脑膜瘤是后颅窝肿瘤的一个独特亚群,需要术前精心规划,并在术中就窦处理做出决策。该研究强调了个体化手术策略的重要性,并突出了放射外科在有效管理残留病变方面的作用。

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