Complete Obstruction Of The Superior Sagittal Sinus Meningioma Resection

Meningioma are generally benign tumors, the most commonin the centralnervous system. Generally speaking, the main part of ameningioma of parasagittalsinus, sellar, convexity etc., mainly occurs in parts of the olfactory sulcus, sphenoidridge, cerebellopontine angle.Among them, most of WHO gradeI meningiomas, WHO II about4.7%-7.2%,WHO III about1.0%-2.8%. WHO IIgrade, WHO grade III meningiomas, and even a few WHO grade I meningiomas in thegrowth process, often involvingthe intracranial venous system, somecommon infringement comprises thesuperior sagittal sinus, cavernous sinus, the centralsulcus veins.Meningioma incidence of intracranial tumor13%-26%, itsgrowth speed isslow, typically occurs in middle-aged men and women40-60years ofage,the incidence rate is about1:2. Most meningiomas are benign tumor, only2%-10%has a malignant growth behavior.The superior sagittal sinus (superior sagittal sinus) for dural sinus, located inthe cerebral falx attachment margin, dural and dural sinus, venous blood was collectedfrom cerebral hemisphere on the upper part of the side and the inner side of the upperpart of the cerebrospinal fluid, as well as byarachnoid granulations backflow, back intothe torcular, responsible for regulating intracranial pressure and drainage ofintracranial blood functionetc.. According to the growth pattern of the tumor and itsrelationship with the surrounding tissue of superior sagittal sinus is different, canbe divided into8types, on the basis of this, some scholars will be divided into3kindsof situation. Epilepsy is a complete obstruction of the superior sagittalsinusmeningioma was the most common clinical features, more than half of thepatients showed the symptoms. Then the motor or sensory nervedysfunction, theoccurrence rate of up to40%, again for the headache,mentalabnormalities, head swelling, the rates were12%,10%,3%. In addition, about46.3%ofthe patients showed no positive signs of nervous system. This paper summarizes the patients with superior sagittalsinus, before1/3occlusion of the2012February to2014February, the Shenyang ArmyGeneral Hospital Department of Neurosurgery Liang Yong group treated patients, atotal of4cases. Among the3cases of operation patients,1patients without operation (due to family membersconsider operation riskrefused operation). In3patients,2male patients,2femalepatients (1cases without operation), the maximum age70years old, the youngest30years old. Among them, the examination found1cases, the first symptomwasheadache in1cases, the first symptom of1cases of epilepsy,1cases of limb symptoms.By in-depth analysis of the case, and on the basis of literatureresearch,occlusion completely meningioma complete resection of the preoperativeexamination of the superior sagittal sinus (typing, angiography, MRV, otherimage features), operation treatment (resection, preoperativepreparation,operation approach, tumor resection, involvement sagittal sinus tumorresection and sagittal Dou Zhongjian), complete obstruction of the superior sagittalsinus (sinus cavity in judging method of clipping test), control ofbleeding, postoperative application of microscopy (step-down method inarteryembolism, venous phlebotomy, intraoperative), othertreatments(radiotherapy, hydroxyurea chemistry treatment and rehabilitation afteroperation (rehabilitation), recurrence, postoperative) are discussed in detail, forthe complete obstruction of the superior sagittalsinusmeningioma resection provides certain guiding significance.