Features of diagnosis and surgical treatment of acute dislocation syndrome in patients with intracranial cystic meningiomas

oleh: Long Jiang, Mikhail S. Kvasha, Kostyantyn M. Herasenko, Oleg P. Robak, Natalia Y. Dmitrieva, Inna M. Ivanovich

Format: Article
Diterbitkan: Romodanov Neurosurgery Institute 2019-03-01

Deskripsi

Objective: to determine the peculiarities of diagnosis, the clinical course of dislocation syndrome (DS) in patients with cystic meningiomas, depending on the shape and degree of brain dislocation and methods of their surgical treatment.Research objectives: to study the results of treatment of patients with DS in the postoperative period, depending on the form and degree of DS.Materials and methods. There have been conducted clinical and instrumental examinations, as well as surgical treatment of 38 (100 %) patients with cystic meningiomas, who were hospitalized to the Department of Non-Cerebral Tumors and Endoscopic Neurosurgery, State Institution of Romodanov Neurosurgery Institute of NAMS of Ukraine, in 2010–2017. Thirty (78.94 %) patients had acute DS before the operation and 18 (47.36 %) patients experienced it in the postoperative period. The selection criteria for patients was DS along with cystic meningiomas aged 20 to 70 years old, without combined TBI, abscesses and somatic pathology. The female patients 2.1-fold prevailed (26:12) over the male patients.Results. In the case of the cingular dislocation, good treatment results occurred in 73.4 % of cases. With temporal tentorial dislocation, in 35.78 % of cases the results of treatment were negative, and with temporo-tentorial and foraminal dislocations the results of treatment were negative in almost 100 % of cases.Conclusions. The dislocation complications could be prevented with methods reducing elevated intracranial pressure, eliminating the insertion of structures of the great brain by radical removal of cystic meningiomas using modern surgical technologies and modern pathogenetic early complex drug intensive care.