29
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Microsurgical Treatment for Central Gyrus Region Meningioma With Epilepsy as Primary Symptom

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The objective of this article was to investigate the operation outcome, complications, and the patient’s quality of life after surgical therapy for central gyrus region meningioma with epilepsy as the primary symptom.

          Methods

          All patients get at least 6 months of follow-up (range, 6–34 mo) after surgery. They underwent preoperative magnetic resonance imaging and video electroencephalography, and their clinical manifestations, imaging characteristics, microsurgical methods, and prognosis were retrospectively analyzed.

          Results

          The meningioma was located in the front and back of the central sulcus vein in 3 and 2 patients, respectively; in the compressed precentral gyrus and central sulcus vein in 3 patients; and in the precentral gyrus and postcentral gyrus each in 1 patient; beside the right sagittal sinus and invaded a thick draining vein on the brain surface in 1 patient and beside the right sagittal sinus and close to the precentral gyrus in 2 patients; invaded the superior sagittal sinus in 8 patients; crossed the cerebral falx and compressed cortex gyrus veins in 1 patient; invaded duramater and irritated skull hyperplasia in 3 patients; invaded duramater and its midline infiltrated into the superior sagittal sinus, was located behind the precentral gyrus, and enveloped the central sulcus vein. They were resected and classified by Simpson standards: 17 of the 26 patients had grade I, 6 patients had in grade II, and 3 patients had in grade III.

          Conclusions

          Resection of central gyrus region meningioma by microsurgical technique avoids injury to the cerebral cortex, central sulcus vein, and other draining veins. Microsurgery improves the total resection rate, reduces recurrence rate, and lowers disability or death rate.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: not found
          • Article: not found

          The recurrence of intracranial meningiomas after surgical treatment.

          D. Simpson (1957)
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery.

            To compare standard anterior temporal lobectomy (ATL) with selective amygdalohippocampectomy (SAH) for postoperative seizure control in temporal lobe epilepsy (TLE).
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Results of attempted radical tumor removal and venous repair in 100 consecutive meningiomas involving the major dural sinuses.

              Radical removal of meningiomas involving the major dural sinuses remains controversial. In particular, whether the fragment invading the sinus must be resected and whether the venous system must be reconstructed continue to be issues of debate. In this paper the authors studied the effects, in terms of tumor recurrence rate as well as morbidity and mortality rates, of complete lesion removal including the invaded portion of the sinus and the consequences of restoring or not restoring the venous circulation. The study consisted of 100 consecutive patients who had undergone surgery for meningiomas originating at the superior sagittal sinus in 92, the transverse sinus in five, and the confluence of sinuses in three. A simplified classification scheme based on the degree of sinus involvement was applied: Type I, lesion attachment to the outer surface of the sinus wall; Type II, tumor fragment inside the lateral recess; Type III, invasion of the ipsilateral wall; Type IV, invasion of the lateral wall and roof; and Types V and VI, complete sinus occlusion with or without one wall free, respectively. Lesions with Type I invasion were treated by peeling the outer layer of the sinus wall. In cases of sinus invasion Types II to VI, two strategies were used: a nonreconstructive (coagulation of the residual fragment or global resection) and a reconstructive one (suture, patch, or bypass). Gross-total tumor removal was achieved in 93% of cases, and sinus reconstruction was attempted in 45 (65%) of the 69 cases with wall and lumen invasion. The recurrence rate in the study overall was 4%, with a follow-up period from 3 to 23 years (mean 8 years). The mortality rate was 3%, all cases due to brain swelling after en bloc resection of a Type VI meningioma without venous restoration. Eight patients--seven of whom harbored a lesion in the middle third portion of the superior sagittal sinus--had permanent neurological aggravation, likely due to local venous infarction. Six of these patients had not undergone a venous repair procedure. The relatively low recurrence rate in the present study (4%) favors attempts at complete tumor removal, including the portion invading the sinus. The subgroup of patients without venous reconstruction displayed statistically significant clinical deterioration after surgery compared with the other subgroups (p = 0.02). According to this result, venous flow restoration seems justified when not too risky.
                Bookmark

                Author and article information

                Journal
                J Craniofac Surg
                J Craniofac Surg
                SCS
                The Journal of Craniofacial Surgery
                Lippincott Williams & Wilkins
                1049-2275
                1536-3732
                September 2014
                10 September 2014
                : 25
                : 5
                : 1773-1775
                Affiliations
                [1]From the Departments of *Neurosurgery and †Neurosurgical Intensive Care Unit, Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong, China.
                Author notes
                Address correspondence and reprint requests to Peng Sun, MD, Department of Neurosurgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong 266003, China; E-mail: sunpengqd@ 123456163.com
                Article
                SCS31430 00043
                10.1097/SCS.0000000000000889
                4212812
                24999673
                58a1786d-c09a-4199-9e9e-26e5f99d8555
                Copyright © 2014 by Mutaz B. Habal, MD

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited.

                History
                : 16 November 2013
                : 9 February 2014
                Categories
                Clinical Studies
                Custom metadata
                TRUE

                microsurgery,meningioma,central gyrus region,epilepsy
                microsurgery, meningioma, central gyrus region, epilepsy

                Comments

                Comment on this article