Microsurgical Treatment for Parasagittal Meningiomas at the Central Cortex / 中国微创外科杂志

ABSTRACT

Objective To study the surgical skills for parasagittal meningioma at the central cortex. Methods A total of 32 patients with parasagittal meningiomas at the central cortex were treated with microsurgery. Through the arachnoid interfaces between the tumor and the brain tissue, the tumor was removed piece by piece. The vein of central sulcus, other draining veins, and normal brain tissues were protected, and the involved sagittal sinus was appropriately treated. Results Simpson Ⅰ, Ⅱ, and Ⅲ grades resection was achieved in 17 (53.1%), 11(34.4%), and 4 (12.5%) of the 32 patients respectively. None of the patients died. Two patients developed cerebral edema and infarction and were cured by surgical decompression. Hemiparalysis was deteriorated in 10 patients, 8 of them recovered spontaneously in 1 to 6 weeks, and the other 2 developed hemiparesis. Among the patients, 21 patients were followed up for 3 months to 5 years. 4 patients had recurrent meningioma in 1 to 3 years after the operation (Ⅱ grade resection in 2 and Ⅲ grade resection in 2). Conclusions For parasagittal meningiomas at the central cortex, preoperation imaging evaluation and microsurgical techniques are key factors for complete resection and surgical outcomes. The vein of central sulcus, other draining veins, and normal brain tissues should be protected during the procedure.