Microsurgery for tentorial meningioma:report of 89 cases

Objective To summarize the experience of microsurgery for tentorial meningioma.Methods The clinical symptom,neuroimaging data,surgical records,pathological findings and early postoperative complications of tentorial meningioma were analyzed retrospectively in 89 patients treated by microsurgery from May 1993 to May 2006.The most common symptoms of the patients were headache in 54 cases(60.7%),dizziness in 29(32.6%),gait disturbance in 34(38.2%),hearing loss in 27(30.3%),and facial pain in 20(22.5%).The main neurological signs were ataxia in 38 cases(42.7%),motor and sensory disturbance in 31(34.8%),and cranial nerve damage in 48(53.9%).Most cases had obvious and uniform enhancement on both T1-and T2-weight MRI.Results Sixty-five tumors(73.0%)were totally removed and 23 subtotally resected(Okudera-Kobayashi Ⅳ andⅤ).The complication incidence and fatality rate were 22.5% and 1.1% respectively.Conclusion The site of tumor and relationship with the neurovascular structures are the important criteria for choosing the best surgical approach.If a complete resection presents an unacceptable risk of neurological deficit,then a subtotal removal should be considered.