Diagnosis and surgical treatment of intraparenchymal sylvian fissure meningioma

Abstract

To describe the characteristics of patients diagnosed with intraparenchymal sylvian meningioma at our department. A retrospective review was performed over 5 patients with intraparenchymal sylvian fissure meningioma confirmed by histopathology and receiving treatment at our department during January 1997 to September 2008. The mean age was 19.4 years old and there were 3 males and 2 females. On CT scanning, intraparenchymal sylvian meningioma was iso- or slightly hyper-dense masses. On MR imaging, tumors showed iso- or hypo- intense signal on T1WI and hyperintense signal on T2WI. After contrast enhancement, T1-weighted images revealed well-demarcated enhancing masses and intimately associated with the middle cerebral artery and its branches in the sylvian fissure. All the patients underwent craniotomy. As a rare disease with radiographic characteristics similar to those of general meningiomas, intraparenchymal sylvian fissure meningioma does not adhere to the dura matter but adhere to or even encase the middle cerebral artery and its branches in the sylvian fissure. All of the above have differential values. During the surgical procedures, a proper handling of tumor and encompassed main trunk of middle cerebral artery and its branches is crucial to patient prognosis.