Superior Sagittal Sinus Obstruction by Giant Meningiomas: Is Total Removal Feasible?
| Autor: | Guidong Song, Zhixian Gao, Xingchao Wang, Ruofei Wu, Peng Zhang, Chaocai Zhang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Decompressive Craniectomy medicine.medical_specialty medicine.medical_treatment Neurosurgical Procedures Meningioma 03 medical and health sciences Postoperative Complications 0302 clinical medicine Meningeal Neoplasms medicine Humans Karnofsky Performance Status Retrospective Studies Hematoma Epilepsy business.industry Skull Perioperative Middle Aged Plastic Surgery Procedures Microsurgery medicine.disease Cranioplasty Tumor Burden Surgery Paresis SSS Treatment Outcome 030220 oncology & carcinogenesis Feasibility Studies Female Decompressive craniectomy Neurology (clinical) Neurosurgery Neoplasm Recurrence Local Superior Sagittal Sinus business 030217 neurology & neurosurgery Superior sagittal sinus |
| Zdroj: | World Neurosurgery. 94:111-119 |
| ISSN: | 1878-8750 |
| Popis: | Objective To present our experience with microsurgical technique for patients with giant meningiomas (maximum diameter ≥7 cm) that obstruct the superior sagittal sinus (SSS). Methods All patients who were preoperatively diagnosed (between 2010 and 2014) with giant meningiomas involving the SSS in Ward 10 at the Neurosurgery Department of Beijing Tiantan Hospital were enrolled in this study. Patient charts, imaging findings, and outcomes were examined. Results The study included 6 male and 4 female patients with a mean age of 46.8 ± 10.7 years. The tumor sizes varied from 7 to 12 cm (mean, 8.8 ± 2.0 cm). All patients underwent customized craniotomies, and aggressive surgery for resection of the invaded SSS was performed. Simpson grade I removals were achieved in all cases. No cases of perioperative mortality occurred. Three patients required cranioplasty as a result of a decompressive craniectomy that was performed during the primary surgery. Histologic examinations showed 1 malignant and 9 benign meningiomas. During the follow-up period (mean, 29.0 ± 9.7 months), recurrence/progression occurred in 1 patient, and 1 patient was lost to follow-up. The recent Karnofsky Performance Score was 80 ± 32.3 and was improved in 5 patients and stabilized in 3 patients. In addition, 7 patients lived independently. Conclusions The rigorous preservation of cortical veins, draining veins, and eloquent areas should be implemented during the resection of large tumors that obstruct the SSS. Suitable individualized approaches associated with full exposure and low cerebral perfusion pressure levels after surgery are critical for favorable results, and the reconstruction of the SSS may not be necessary. |
| Databáze: | OpenAIRE |
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