Mori Y, Shibuya M, Sugita K, Nagasaka T
Department of Neurosurgery, Nagoya University School of Medicine.
No Shinkei Geka. 1994 Dec;22(12):1147-51.
A case of deep sylvian meningioma without dural attachment in a 12-year-old boy was reported. He had been suffering from severe headache for a month. Neurological examination was normal. CT scan and MR images showed a well-enhanced 7 cm mass lesion with small cysts, located in the left sylvian fissure. Peritumoral edema was slight and the midline structures were minimally shifted in spite of its large size. A fronto-temporal craniotomy was made and the tumor was grossly totally removed. The tumor had no dural attachment and existed in the left sylvian fissure, involving the middle cerebral artery and its branches. The histological diagnosis was transitional meningioma without malignancy. The postoperative course was uneventful except for transient mild left oculomotor palsy for several days. He is doing well now one year after the surgery and follow-up MR images showed no recurrence. Intracranial meningioma is rare in children. According to the literature, meningioma in children is slightly more frequent in males. There is a higher incidence of lack of dural attachment and cystic tumors than in adults. Deep sylvian meningioma without dural attachment is also very rare. Including our case, 13 cases of deep sylvian meningioma were reported in the literature. Four of them were under 20 years old. We report this case in detail with other cases reported previously.
报告了一例12岁男孩的深部大脑外侧裂脑膜瘤，该肿瘤无硬膜附着。他头痛严重已有一个月。神经系统检查正常。CT扫描和磁共振成像显示，位于左侧大脑外侧裂的一个7厘米大小、强化良好且伴有小囊肿的肿块病变。尽管肿瘤体积较大，但瘤周水肿轻微，中线结构仅有轻微移位。进行了额颞开颅手术，肿瘤大体上被完全切除。肿瘤无硬膜附着，位于左侧大脑外侧裂，累及大脑中动脉及其分支。组织学诊断为无恶性特征的过渡型脑膜瘤。术后过程顺利，仅出现了几天短暂的轻度左侧动眼神经麻痹。术后一年他目前情况良好，随访磁共振成像显示无复发。颅内脑膜瘤在儿童中罕见。根据文献，儿童脑膜瘤在男性中略为常见。与成人相比，无硬膜附着和囊性肿瘤的发生率更高。无硬膜附着的深部大脑外侧裂脑膜瘤也非常罕见。包括我们的病例在内，文献中报道了13例深部大脑外侧裂脑膜瘤。其中4例年龄在20岁以下。我们详细报告了该病例以及之前报道的其他病例。
