Diagnosis And Surgical Treatment Of Tentorial Meningiomas

Objective:To improve the diagnosis and treatment of tentorial meningiomas, the anatomical, epidemiologic, clinical and radiological features, diagnosis, surgical management, complications, pathological features and final outcome of patients with tentorial meningioma are described.Subjects and Methods:A series of62patients with tentorial meningiomas consecutively operated in Qilu Hospital of Shandong University between January2010and January2014is analyzed, and retrospective analysis was performed. All the patients were diagnosed by computed tomography and magnetic resonance imaging; Magnetic resonance angiography was performed in17patients too.1patient had brain angiography examination and embolization before operation.Results:Forty-eight patients were female and fourteen male. Mean age was55.35years. The average duration of presenting symptoms was22.9months. The typical clinical manifestations were headaches, ataxia, nausea and vomiting as well as vision and visual field changes. Extent of tumor resection was Simpson Grade I in9patients, Grade II in32patients. The postoperative complications were infections and subcutaneous hydrops. The mortality is1.62%. The follow-up was available in32patients for a period ranging from0.5to3years. No patients had tumor recurrence.Conclusion:(一)The lack of early syptoms and signs adds the difficulty of first stage diagnosis. The signs and symptoms of increased intracranial pressure and cranial nerves dysfuction were the most common findings of late stage. The diagnosis of tentorial meningiomas were mainly depend on Imaging examination. (二)Both Computed Tomography and Magnetic Resonance Image are recommended for comparison to achieve precise diagnosises. Magnetic resonance angiography has proved to be a valuable tool for blood supply of tumors and the patency of dural sinuses-No recommendation for routinely digital substration angiography, except for embolization before operation.(三)Venous sinuses should be managed carefully, especially those invaded in by the meningiomas. Avoid forcible resections of meningiomas in unsuitable conditions.The surgical results of59patients were satisfactory.The patients resumed normal life with a low mortality. Temporary or permanent complications would occur.