【摘要】 目的探讨镰幕结合处脑膜瘤的临床特点、影像学表现和显微外科手术注意事项。方法回顾分析１４例镰幕结合处脑膜瘤患者的临床资料。所有患者术前均进行了ＣＴ检查，１０例患者同时进行了ＤＳＡ检查，６例行ＭＲＩ检查，２例行ＭＲＡ检查。１０例行枕下经小脑幕入路，其中７例为病灶侧向上，３例为病灶侧向下，３／４俯卧位；３例行幕下小脑上入路，１例行侧脑室后部入路。结果１４例中，肿瘤全切除１２例，近全切除２例。术后发生脑内血肿２例，肿瘤残腔血肿１例，２例行血肿清除。平均随访４５年，全部患者恢复正常工作和学习，１例有永久性同向偏盲，１例有滑车神经麻痹。结论镰幕结合处脑膜瘤是一种可手术治疗的肿瘤。更多还原

【Abstract】 Objective To study the clinical characteristics, neuroimaging presentations, operative warming events and the results of surgical treatment of meningioma of the falcotentorial junction. Methods The clinical data of 14 patients with meningioma of the falcotentorial junction were retrospectively analysed. Preoperative examinations included head CT in all patients, DSA in 10, MRI in 6, and MRA in 2. 10 patiens was operated on via suboccipital transtentorial approach,of which, operated side up position in 7 patients, three quarter prone operated side down position in 3. Three 3 patients was operated on via trans infratentorial supracerebellar approach. One via translateral ventricle trigone approach. Results Of 14 patients, 12 received total remoral of meningioma and 2, subtotal resection. Intracerebral hematoma occurred postoperatively in 2 patients and, intratumoral residual cavity hematoma in 1. Two patients′ hematomas were evaculated, and another patient′s hematoma was conservatively treated. Average follow up period was 4 5 years. All patients resumed their normal work and study. One patient had permanent homonymous hemisnopsia, and one had trochlear paralysis. Conclusions Meningiomas of the falcotentorial junction were operable. With some acceptable morbidity, perfect surgical results can be obtained.更多还原