Preoperative diagnostic value of imaging and microsurgical treatment for parasagittal meningiomas in central gyrus region

Abstract

Objective To discuss the value of the preoperative image assessment and surgical strategy of parasagittal meningiomas in central gyrus region, in order to raise the resection rate of tumors and surgical effects. Methods 25 patients with parasagittal menigioma in central gyrus region were examined by routine MRI and MRV to evaluate the blood supplies of the tumor, degree of involvement of the sagittal sinuse and collateral veins. During the operation, a frontoparietal cross-midline horseshoe incision was performed. The parasagittal blood supplies were blocked at first and then the tumors were removed piece by piece. The Rolandic veins and compensative veins were protected. The sagittal sinuses were appropriately dealt with. Results The visualization of 25 parasagittal meningiomas in central gyrus region invading the sagittal sinuses and the draining veins was achieved through MRV and MRI scanning. The results were highly coincidence with the findings in the operation.18 tumors were removed with SimpsonⅡgrade, and 7 Simpson Ⅳ. Postoperatively, 5 patients developed hemiparesthesia, 3 hemiparesis, and 2 mental disorders. All the complications were recovered satisfactorily during follow-up period. Conclusions Sufficient preoperative imaging evaluation, MRV combined with conventional MRI, could sensitively show the degree of involvement of the sagittal sinus and collateral veins. Skillful microsurgical technique was helpful to protect important drainage veins, collateral veins and sinuses, and increase surgical outcome in patients with parasagittal menigioma in central gyrus region. Key words: Central gyrus region; Sagittal sinus; Menigioma; Magnetic resonance venography; Microsurgery