Yamashiro Kei, Adachi Kazuhide, Higashiguchi Saeko, Fujiwara Eiji, Hayakawa Motoharu, Hasegawa Mitsushiro, Hirose Yuichi
Department of Neurosurgery, Fujita Health University Okazaki Medical Center, Aichi, Japan.
Department of Neurosurgery, Fukuoka University, 7 - 45 - 1, Nanakuma, Jonan-Ku, Fukuoka, 814 - 0810, Japan.
Acta Neurochir (Wien). 2025 Apr 7;167(1):100. doi: 10.1007/s00701-025-06510-x.
Knowledge of the location of tumor-feeding arteries is necessary for the safe surgery of intracranial meningiomas. Hence, this retrospective study aimed to comprehensively analyze the distribution of tumor-feeding arteries.
Patients who underwent intracranial meningioma surgery at our institution between 2015 and 2023 were included in this study. The tumor attachment sites and tumor-feeding arteries were evaluated based on the results of preoperative examinations. The tumor attachment sites were classified as non-skull bases (convexity, parasagittal, and falx) or skull bases (anterior skull base, sphenoid ridge, sphenopetroclival, petrous, tentorial, cerebellar convexity, and foramen magnum). These tumors were further subdivided according to their attachment areas.
Among the 180 patients included, the tumor-feeding arteries were identified in 177 patients (98.3%). In 67 patients with non-skull base meningiomas, the middle meningeal artery primarily functioned as a tumor-feeding artery in the anterior and middle regions (78 of 108 feeding arteries, 72.2%), while the extracranial artery served as a tumor-feeding artery in the posterior region (20 of 37 feeding arteries, 54.1%). Conversely, skull base meningiomas exhibited a higher frequency of having tumor-feeding arteries derived from the internal carotid artery (132 of 278 feeding arteries; 47.5%); these tumor-feeding arteries are often found at the deepest part of the surgical field during tumor resection and require careful intraoperative handling.
Tumor-feeding arteries originate from different dural arteries depending on the tumor attachment site. These findings could help enhance surgical safety, especially in patients with meningiomas who have not undergone preoperative angiography.
了解肿瘤供血动脉的位置对于颅内脑膜瘤的安全手术至关重要。因此，本回顾性研究旨在全面分析肿瘤供血动脉的分布情况。
本研究纳入了2015年至2023年在我院接受颅内脑膜瘤手术的患者。根据术前检查结果评估肿瘤附着部位和肿瘤供血动脉。肿瘤附着部位分为非颅底（凸面、矢状窦旁和大脑镰）或颅底（前颅底、蝶骨嵴、蝶岩斜坡、岩骨、小脑幕、小脑凸面和枕骨大孔）。这些肿瘤再根据其附着区域进一步细分。
在纳入的180例患者中，177例（98.3%）发现了肿瘤供血动脉。在67例非颅底脑膜瘤患者中，脑膜中动脉主要在前部和中部区域作为肿瘤供血动脉（108条供血动脉中的78条，72.2%），而颅外动脉在后部区域作为肿瘤供血动脉（37条供血动脉中的20条，54.1%）。相反，颅底脑膜瘤有更高比例的肿瘤供血动脉来自颈内动脉（278条供血动脉中的132条；47.5%）；这些肿瘤供血动脉在肿瘤切除过程中常位于手术视野的最深部位，术中需要小心处理。
肿瘤供血动脉根据肿瘤附着部位的不同起源于不同的硬脑膜动脉。这些发现有助于提高手术安全性，尤其是对于未进行术前血管造影的脑膜瘤患者。
