建立脑膜瘤手术治疗的有效方法

M. Moreanu, M. Cozma, A. Sandu
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摘要

问题说明:脑膜瘤是良性轴外肿瘤,起源于脑膜蛛网膜细胞,占颅内原发肿瘤的20%。脑膜瘤的外科治疗是最具挑战性的手术之一,对大脑关键的神经血管中心有很高的影响风险。我们的研究从一位50岁的女性病例开始,试图确定临床前脑检查与完善的外科手术相结合的方式,从而有效和有策略地治疗脑膜瘤。病例介绍:患者的临床背景包括额部头痛、罕见的癫痫发作危象和突发性头晕。除了MRI显示在额眶左侧空间呈均匀不规则扩张的肿瘤过程外,还进行了其他一些检查,如数字血管造影和计算机断层扫描。治疗主要以神经外科干预为主,目的有:排斥脑膜瘤、建立解剖病理诊断和制定治疗方案。手术方法包括一步一步切开,肿瘤碎裂和辛普森2切除。最后的结果是令人满意的——病人恢复了平衡。结论与意义:更好地了解脑膜瘤的神经外科治疗步骤将有助于找到改善患者治疗和生活质量的策略。
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Establishing the proper approach to an effective surgical treatment for the Meningioma
Statement of the Problem: Meningiomas are benign extra-axial tumors, originating from the meningeal arachnoidal cells, making up 20% of the intracranial primary tumors. Surgical management of meningiomas is one of the most challenging procedures posing a high risk of affecting the critical neurovascular centers of the brain. Our study attempts to identify the way paraclinical brain investigations coupled with a well-established surgical procedure lead to an efficient and strategic treatment of meningioma, starting with a case of a 50-year-old woman. Case presentation: The clinical background of the patient included frontal headaches, rare epileptic crises, and sudden dizziness. In addition to the MRI which presented a homogenous irregular expanding tumor process in the frontal-orbital left space, several other investigations such as Digital Angiography and Computed Tomography were performed. The treatment was mainly focused on the neurosurgical intervention, having several purposes: rejecting the meningioma, establishing the anatomopathological diagnosis and developing the therapeutic plan. The surgical approach involved a step-by-step incision, tumor fragmentation and Simpson 2 excision. The final result was favourable – the patient regained her balance. Conclusion & Significance: Getting a better understanding of the neurosurgical steps of treating meningiomas will lead to finding strategies that will improve the patient's treatment and his quality of life.
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