Diagnosis And Treatment Of Tentorial Meningiomas

Objective: To improve the diagnosis and treatment of tentorial meingiomas, the epidemiologic, clinical and radiological features, diagnosis, surgical management, complications, pathological features and final outcome of patients with a tentorial meningioma are described.Methods: A series of 72 patients with tentorial meningiomas consecutively operated in Qilu Hospital of Shandong University between February 1990 and May 2005 is analyzed. All the patients were diagnosed by computed tomography; in 41 of them a magnetic resonance imaging was performed; Magnetic resonance angiography was performed in 7 patients too.Results: Fifty-three patients were female and 19 male. Mean age was 49.8 years (22-75). The average duration of presenting symptoms was 20.9 months. The most common complaints at presentation were headaches (69.4%), gait ataxia (45.8%). Tentorial meingiomas are classified into 6 subgroups according to tumor site. Extent of tumor resection was Simpson Grade I in 15 patients, Grade II in 50 patients, Grade IV in 7 patients. The postoperative morbidity was 23.6% and mortality = 2.8%. The follow-up was available in 54 patients for a period ranging from 0.5 to 11.5 years (mean, 62.7 months). Of these, 48 patients (88.9%) have resumed normal life activity. Three patients had tumor recurrence and two underwent reoperation.Conclusions: 1,Tentorial meningiomas occur infrequently and mainly in women of middle age. The average duration of presenting symptoms in male patients is shorter. 2,The signs and symptoms of increased intracranial pressure and cerebellar ataxia were the most common findings. The diagnosis of tentorial meningiomas were mainly depend on neuroradiology, and the meningeal sign would help to it. 3, Magnetic resonance angiography has proved to be a valuable tool for blood supply of tumors and the patency of dural sinuses. There would be hence little justification for...