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首页> 外文期刊>Neurology India. >Large/giant meningiomas of posterior third ventricular region: Falcotentorial or velum interpositum?
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Large/giant meningiomas of posterior third ventricular region: Falcotentorial or velum interpositum?

机译：后第三脑室区域的大/巨大脑膜瘤：al囊性或子宫内膜炎？

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Surgical excision of rare, large-to-giant posterior third ventricular (PTV) meningiomas [including velum-interpositum meningiomas (VIM; postero-superior venous complex displacement; without falco-tentorial attachment) and falco-tentorial meningiomas (FTM; falco-tentorial attachment; displacing major veins antero-inferiorly)] is extremely challenging. To study the management nuances in the excision of large-to-giant PTV meningiomas. Tertiary care referral center. Four patients with large (> 3 cm; n = 2) and giant (> 5 cm; n = 2) meningiomas (FTM = 2; VIM = 2, mean tumor size = 4.9 cm) underwent occipital transtentorial approach (OTT) for tumor excision. One also underwent a second-stage supracerebellar infratentorial (SCIT) approach. The side of approach was determined by lateral tumor extension and venous displacement (right = 3, left = 1). Near-total removal or subtotal excision (< 10% remaining) with radiotherapy was performed in 2 patients each, respectively. At follow-up (mean: 14.75 months), clinical improvement without tumor recurrence/re-growth was achieved. Extent of excision was determined by position of great vein of Galen; tumor attachment to falco-tentorium or major veins; its consistency; its lateral and inferior extent; and, presence of a good tumor-neuraxial arachnoidal plane. OTT is the preferable approach for large-to-giant meningiomas as it provides a wider corridor and better delineation of tumor-neurovascular arachnoidal interface.
机译：手术切除罕见的大而硕大的后第三脑膜（PTV）脑膜瘤[包括膜间-脑膜脑膜瘤（VIM;后上静脉复杂性移位;无falco-tentorial附件）和falco-tentorial脑膜瘤（FTM; Falco-tentorial）附件;将大静脉前后移位）]极具挑战性。研究大到大型PTV脑膜瘤切除术中的管理差异。三级保健转诊中心。对四名大（> 3 cm; n = 2）和大（> 5 cm; n = 2）脑膜瘤（FTM = 2; VIM = 2，平均肿瘤大小= 4.9 cm）的患者进行了枕枕穿刺入路（OTT）治疗切除。一个人还接受了第二阶段的小脑上臂下肌（SCIT）方法。入路的一侧取决于肿瘤的侧向扩展和静脉移位（右= 3，左= 1）。放射治疗分别分别对2例患者进行了近乎完全切除或近乎完全切除（剩余<10％）。随访（平均：14.75个月），没有肿瘤复发/重新生长的临床改善。切除的程度取决于盖伦大静脉的位置。肿瘤附着于al-腱膜或主要静脉;其一致性;其横向和劣等程度;并且，存在良好的肿瘤神经蛛网膜平面。 OTT是大型到大型脑膜瘤的首选方法，因为它提供了更宽的通道和更好地描绘肿瘤-神经血管蛛网膜界面。

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