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Microsurgical treatment for parasagittal meningioma in the central gyrus region
Na Bi1, Rui-Xue Xu, Rong-Yao Liu
1Department of Nursing, Chinese PLA General Hospital, Beijing 100853, P.R. China ; Department of Neurosurgery, The 309th Hospital of PLA, Beijing 100091, P.R. China.
Abstract:
The aim of the present study was to determine the efficacy of microsurgery treatment for parasagittal meningioma in the central gyrus region. A microsurgical technique was used to treat 26 patients with large parasagittal meningioma in the central gyrus region. The Rolandic and draining veins and the peritumoral normal brain tissue were retained, and the associated sagittal sinus was appropriately protected. A Simpson grade I, II or III resection was performed in 8 (30.8%), 12 (46.2%) and 6 (23.1%) patients, respectively, with no post-operative mortalities. Following treatment, 9 patients exhibited hemiparalysis. No tumor recurrence was found in 21 patients during the follow-up examination. The treatment protocol described in the current study included sufficient pre-operative imaging evaluations, a skilled microsurgical technique, improved protection of the Rolandic vein and treatment of the sagittal sinus, and was found to significantly increase the total tumor removal rate and decrease post-operative recurrence.
Insights
Microsurgery effectively treats large parasagittal meningiomas in the central gyrus, achieving high resection rates with minimal recurrence. This technique prioritizes preserving critical brain structures and venous drainage, leading to favorable patient outcomes.
Area of Science:
- Neurosurgery
- Oncology
Background:
- Parasagittal meningiomas in the central gyrus pose surgical challenges due to their proximity to critical neurovascular structures.
- Effective surgical management is crucial for preventing neurological deficits and tumor recurrence.
Purpose of the Study:
- To evaluate the efficacy of a microsurgical technique for treating large parasagittal meningiomas located in the central gyrus region.
- To assess tumor resection rates, complication incidence, and recurrence rates following microsurgical intervention.
Main Methods:
- A cohort of 26 patients with large parasagittal meningiomas underwent microsurgery.
- The surgical approach focused on preserving the Rolandic veins, peritumoral brain tissue, and the sagittal sinus.
- Simpson grade I, II, or III resections were performed based on tumor extent and adherence.
Main Results:
- No post-operative mortality was observed in the study cohort.
- Simpson grade I, II, and III resections were achieved in 30.8%, 46.2%, and 23.1% of patients, respectively.
- Tumor recurrence was not detected in 21 patients during follow-up; 9 patients experienced hemiparalysis post-operatively.
Conclusions:
- Microsurgery is an effective treatment for large parasagittal meningiomas in the central gyrus.
- The described protocol, emphasizing meticulous surgical technique and neuroprotection, enhances tumor removal and reduces recurrence.
- Careful pre-operative evaluation and skilled microsurgical execution are vital for successful outcomes.
