Microsurgical Treatment Of Tentorial Meningioma

Objective: through the tentorium meningioma type,anatomical characteristics,clinical manifestations,imaging examination,surgical approach,intraoperative treatment of venous sinus,postoperative complications,pathological results,influence factors and follow-up recurrence were discussed,in order to improve the level of diagnosis and surgical treatment of tentorial meningiomas.Methods: We collected during the period from January 2012 to December 2016,the clinical data from the First Affiliated Hospital of Bengbu Medical College,46 cases of tentorial meningioma patients,the surgical treatment were retrospectively analyzed.All patients in this group underwent cranial CT examination and head MRI examination,17 cases underwent head MRV.Results: in 46 patients,male 7 cases,female 39 cases,age from 38 to 73 years old,an average of 56.17 years;the course from 30 years 2 days,an average of 21.64 months,the hospitalization time from 14 days to 56 days,average 22.7 days before operation;the main clinical symptoms of headache dizziness,nausea and vomiting,limb ataxia disorder,visual changes,abnormal hearing;operation to achieve Simpson grade I resection in 26 cases,Simpson grade II resection in 16 cases,Simpson grade ?resection in4cases;the main postoperative complications with subcutaneous effusion,cerebrospinal fluid leakage and intracranial infection;1 patients died after the surgery,again for bone flap pressure reduction of 1 cases;43 cases were followed up.The follow-up time of 3 months to 36 months;25 cases of "KPS 5;11 cases of 5" KPS "4;7 cases of 4" KPS "3;3 cases of tumor recurrence,underwent gamma knife tumor after radiotherapy was significantly reduced.Conclusion: the location of tentorial meningioma is deep,located at the base of posterior cranial fossa.Early lack of obvious clinical manifestations makes it difficult to diagnose.Advanced meningioma is often associated with surrounding important nerve and blood vessels and other tissues,which increases the difficulty of surgical resection.Combined with the preoperative imaging and the location and size of tentorial meningioma,individualized selection of the optimal operative approach can effectively improve the resection rate,reduce postoperative complications and improve postoperative functional recovery.