Abstract: Objective To discuss the main points of the resection of lateral ventricle meningioma by neuronavigation microsurgery,and to discuss the experience of prevention of postoperative complications.Methods We followed up 21 casesof lateral intraventricular meningioma from January 2013 to June 2021.The pariet al occipital cortex approach was used for microsurgical resection of the tumor,combined with neuronavigation assistance and intraoperative electrophysiological monitoring for functional protection.The results of tumor resection,pathological results,postoperative complications,postoperative recovery (Karnofsky score) and recurrence were observed.Results Of all the cases,total resection of tumor was performed in 20 cases and subtotal resection was performed in 1 case.The former symptoms were all improved,among which 4 cases had newly developed visual field defect after surgery,2 cases were improved after treatment.3 patients with hydrocephalus (1 improved after cvonservative treatment,2 improvedby ventriculoperitoneal shunt);Subcutaneous effusion and cerebrospinal fluid leakage in 6 cases were cured by lumbar cistern drainage.There were no new cases of hematoma and death in this group.The pathological report suggested meningioma in all patients,among whom WHO Grade II patients received conventional radiotherapy,and no obvious recurrence was found in the follow-up of 0.5~7 years.Conclusion Microsurgical resection of lateral ventricle under neuronavigation is effective and the improvement of microsurgical techniques can effectively avoid complications.

Key words: Neuronavigation, Meningioma of the lateral ventricle, Microsurgical resection

摘要： 目的 探讨神经导航下显微手术切除侧脑室内脑膜瘤的要点,并讨论术后并发症的预防体会。方法 回顾2013年1月~2021年6月侧脑室内脑膜瘤病例21例,结合神经导航辅助及术中电生理监测行功能保护,采用顶枕叶皮质入路显微手术切除肿瘤。观察手术切除效果、术后并发症、术后恢复(Karnofsky 评分)及复发情况。结果 本组全切20例,次全切1例。术前症状均好转,术后新发视野缺损患者4例,2例经治疗后好转;新发脑积水3例(1例保守治疗后好转,2例行脑室(颞角)腹腔分流术);皮下积液及脑脊液漏6例,经腰大池引流后均治愈。本组未出现新发血肿及死亡病例。病理报告提示均为脑膜瘤,其中WHOⅡ级的患者均常规行放射治疗,术后随访0.5~7年未见明显复发。结论 神经导航下侧脑室显微手术切除疗效确切,全切肿瘤及显微手术技巧的提高有效避免并发症发生。

关键词: 神经导航, 侧脑室脑膜瘤, 显微外科