Tentorial Meningiomas
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WE REPORT OUR experience with and long-term results of 37 patients with tentorial meningiomas who underwent surgery between 1972 and 1993. The average age was 43 years, and the mean duration of symptoms was 36 months. Headache (83.8%) and extremity or gait ataxia (35.1%) were the most common complaints. On neurological examination, signs of elevated intracranial pressure and cerebellar deficits (51.4%) were the most common findings, followed by third nerve involvement (35.1%). Computed tomography, angiography, and, in recent years, magnetic resonance imaging were used as diagnostic tools and for planning the surgical procedure. According to the primary site of attachment, the tentorial meningiomas were divided into three subgroups: medial, lateral, and falcotentorial. The lateral and medial tumors, with mainly supratentorial development, were approached from above by using a temporal, temporooccipital, or parietooccipital craniotomy. For tumors developing mainly in the posterior cranial fossa, suboccipital craniectomy was performed. In six patients who showed medial tentorial and petrous apex attachment, a combined subtemporal transpetrosal and retromastoid approach was performed. In 31 patients, the tumors were totally removed, and, in 6 patients, only subtotal excision could be done. Seven patients had postoperative complications, but only one of them died of severe brain edema. Our mortality rate was 2.7%. In this article, appropriate preoperative studies, surgical techniques, and surgical results are discussed.TUMORS of the foramen magnum and the upper part of the cervical spinal cord are often initially seen with confusing clinical syndromes that are frequently ascribed to a conversion hysteria or fibromyositis. In a major review of such tumors, Dodge et al1stated, "Unless the physician obtains an accurate history and attributes sufficient significance to the patient's often bizarre and at times seemingly functional complaints, he is likely to deny the patient his ultimate opportunity for cure." Despite this warning, it seems that scant attention has been given to the role of the patient's history in the early diagnosis of such tumors, and diagnostic studies are only undertaken when signs of spinal cord compression are apparent. The following case report describes a patient in whom the history of recumbent neck pain and electromyographic abnormalities suggested the diagnosis of a meningioma in the upper part of the cervical spinal cord
Foramen magnum
Neck pain
Spinal cord compression
Spinal Cord Neoplasm
Medical History
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Objective To assess the safety of intraoperative blood salvage in resection of meningioma.Methods A total of 134 patients were performed resection of meningioma in Beijing Tiantan hospital from January 1999 to December 2006,and followed up in a period of at least 12 months.Among the patients,89 patients(groupⅠ,male 44,female 45) received intraoperatively salvaged blood and 45 patients(groupⅡ,male 21,female 24) did not.The average follow-up period for group Ⅰand Ⅱ were 25 and 30 months,respectively.During the follow-up period,the recurrent rate and recurrence of extracranial metastatic meningioma were recorded.Results The patients in groupⅠ had significantly higher intraoperative blood loss than those in group Ⅱ,a fewer patients were transfused with banked blood(7.9 % in group Ⅰvs 24.4 % in group Ⅱ,P 0.001).The recurrent rate of the patients undergone Simpson gradeⅠresection were 7.6 % and 11.8 % in 2 groups,respectively(P = 0.75).No extracranial metastases case was found in both groups.Conclusion There is no increasing risk of recurrence or metastasis of meningioma in the patients transfused with intraoperatively salvaged blood during the follow-up study.
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Ten women (age : 42 to 82) with spinal menigiomas were treated surgically between January 1989 and July 2001. All menigiomas were intradural-extramedullary. Histopathological subtypes were meningotheliomatous in four cases (cervical level in two cases and thoracic level in two cases) and psammomatous in six cases (thoracic level). MRI revealed dural tail sign in four cases and CT revealed direct tumor sign (calcification or ossification) in four cases (psammomatous type). Surgical results were excellent except for one recurrence case. Cell counts in the celebro-spinal fluid significantly correlated with the prognosis. (Pearson's correlation coefficient ; P<0.05)
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TUMORS of the foramen magnum and the upper part of the cervical spinal cord are often initially seen with confusing clinical syndromes that are frequently ascribed to a conversion hysteria or fibromyositis. In a major review of such tumors, Dodge et al1stated, "Unless the physician obtains an accurate history and attributes sufficient significance to the patient's often bizarre and at times seemingly functional complaints, he is likely to deny the patient his ultimate opportunity for cure." Despite this warning, it seems that scant attention has been given to the role of the patient's history in the early diagnosis of such tumors, and diagnostic studies are only undertaken when signs of spinal cord compression are apparent. The following case report describes a patient in whom the history of recumbent neck pain and electromyographic abnormalities suggested the diagnosis of a meningioma in the upper part of the cervical spinal cord
Foramen magnum
Neck pain
Spinal cord compression
Spinal Cord Neoplasm
Medical History
Clinical history
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Psammoma body
Ossicles
Ethmoid sinus
Cribriform plate
Orbit (dynamics)
Frontal sinus
Fibroma
Osteoma
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Port (circuit theory)
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