The Surgical Outcome of Parasagittal and Falx Meningioma in the Era of Microsurgery and Computerized Tomography
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In this paper we presant our experience in the surgical treatment of supratentiorial midline meningiomas including 23 parasagittal and 15 falx meningiomas since the introduction of CT and routine use of microsurgical techniques. The immediate and late outcomes were analyzed. There ware 17 meningiomas in the anterior third of the superior sagittal sinus; 15 in the middle third and 6 in posterior third. There ware 12 males and 26 females. The age ranged from 29 to 84 years old with an average of 56.6. Thirty six cases were evaluated with CT preoperatively, and two with magnetic resonance imaging. Surgical excision was performed with microsurgical techniques. The carbon dioxide laser was used in 13 recent cases. The extent of the tumor removal was expressed according to Simpson's classification. Grade I removal was performed in 13 of 17 anterior third tumors; 2 of 15 middle third; and 1 of the 6 posterior third tumors. Grade Ⅱ removal was performed in 2 of the 17 anterior third; 10 of 15 middle third; and 4 of 6 posterior third tumors. Grade Ⅲ removal was performed in 1 anterior third; 2 middle third; and 1 posterior third tumors. GradeⅣ removal was performed in 1 anterior third tumor and 1 middle third tumor. The operative mortality was 2.6% (1 out of 38). Sixteen patients(42.1%) were neurologically intact pre and postoperatively. The functional capability in 24 survivours with the followup period longer than 4 years(mean of 6 years) were: no disability in 3(12.5%). The immediate and late outcomes of present series ware better than those of earlier reported series in which the majority of the cases were diagnosed with angiography and treated with conventional surgical techniques. Early accurate diagnosis with CT scan with refinements of surgical techniques, such as routine use of microsurgery, have improved surgical outcomes, but did not reduce the recurrence rate which was the most ominous factor in terms of long term prognosis in the supratentorial midline meningiomas.
- Yamaguchi University Graduate School of Medicineの論文
Yamaguchi University Graduate School of Medicine | 論文
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