[Current problems in the surgical management of parasellar meningiomas]

In the period from 1967 to 1972, 302 patients suffering from basal parasellar meningiomas were operated on at the Burdenko Institute of Moscow. Further, an analysis of the results obtained in the surgical treatment of 43 patients is given who were operated on in the last two years by employing the microsurgical technique. The considerable advantages of the use of the operating microscope and the microtechnique are shown. The mortality rate was reduced to one half and the radicality increased from 50 to 80--85 per cent. All Tuberculum sellae meningiomas could be removed totally. Also in the presence of bad general conditions of the patients no contraindications were seen but the very last chances were used. Postoperative supervision consisted in measuring and checking the cerebrospinal pressure, intracerebral pressure, interstitial fluid pressure, local and regional blood flow, pCO2 and pO2, electrolyte balance, osmolarity and pH. In this way, low pressure conditions could frequently also be determined. The influence of an early diagnosis on the prognosis of the disease is specially pointed out.