| Objective:parasagittal sinus meningioma (PSM) is a common intracranial benign tumor . As PSM adjacent to the origin in the arachnoid granulations, tumor growth is easy invasion of superior sagittal sinus , also the surrounding tumor is often accompanied by significant cortical vein, so, the radical resection of the meningiomas presents several hazards.This retrospective clinical study is to explore the microneurosurgery technology used in the resection of PSM and the effect of the treatment.Methods: Between January 2003 and March 2010,a series of 86 cases with parasagittal sinus meningiomas underwent micro-neurosurgery in the Neurosurgery Department of the First Affiliated Hospital of Guangxi Medical University. A retrospective analysis is performed on the clinical data of the 32 cases in this series.There were 12 males,20 females,with age between 21~70 years,mean age 45.3 years. Results: 1.presentation of preoperative imageology examination:13 cases are located in the left side , 12 cases in the right side ,7 cases involving bilateral, 11 cases in the anterior third of the sss, 16 cases in the middle third ,5 cases in the posterior third.Bone changes including infiltration or hyperostosis were documented in 8 patients patients.The distinct "dural tail sign" were discovered in 7 cases. In 23 cases,tumor has close relationship with the surrounding cortical drainage.Incomplete occlusion of sss caused by tumor compression or violations were discovered in 19 cases and complete occlusion with good collateral circulation in 13 cases.2. Intraoperatively ,average blood loss was 450ml and important cortical veins around the tumor get good protection;According to Simpson meningiomas resection system, Gradeâ… was achieved in 11 cases (34.4%), Gradeâ…¡in 19 cases (59.4%), Gradeâ…£in 2 cases (6.3%), no resection of gradeâ…¢andâ…¤.3. Postoperative complications: muscle strength decline in 9 cases, which have been varying degrees of muscle recovery after rehabilitation treatment;new epilepsy occurred in 2 cases after surgery; postoperative intracranial hematoma in 2 cases; Patients with postoperative cerebrospinal fluid leakage does not occur; There were no perioperative deaths.4. Followed-up ranged from 1 month to 52 months,mean 32 months.2 patients relapsed.Among the benign meningiomas ,no patient with Gradeâ… andâ…¡resection recur, 1 patient with Gradeâ…£recur. 1 atypical meningioma with Gradeâ…¡recection recur at 6 months after surgury. The quality of life which measured by KPS system were improved obviously afer surgury.Conclusion: 1. The topography, blood supply, the extent of dural involvement and relationships of the parasagittal meningioma with draining veins and the SSS should be established by preoperative evaluation before surgery. It has significant importance to choose the proper surgery approach and reduce surgical complications.2. Application of microneurosurgical techniques can help to reduce blood loss in surgery, protect normal brain tissue and important drainage,thus greatly reduce the incidence of the complication . Not only can we increase the total resection rate of tumor, but also can improve the quality of patients' life after surgery.
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