Objective To investigate the method and efficacy of microsurgery for the parasagittal meningiomas in central sulcus region.Methods Clinical data of 32 patients with parasagittal meningiomas in the central sulcus region who underwent microsurgical resection were analyzed retrospectively. Results SimpsonⅠresection was achieved in 3 patients, SimpsonⅡresection in 15 and Simpson Ⅳ in 14. No procedure-related death and no new seizure. The improvement of disturbance of motor function was observed in 14 patients and the improvement of sensory disturbance was observed in 9. The severe hydrocephalus and cerebral infarction occurred in 1 patient who recovered after decompressive craniectomy. All the patients were followed up for 6 months to 7 years with a mean period of 45 months.The relapse occurred in 6 patients including 2 of Simpson Ⅱ resection and 4 of Simpson Ⅳ, 2 of whom received reoperation.Conclusions Sufficient preoperative evaluation, intraoperative appropriate treatment of draining vein, the rolandic vein and the superior sagittal sinus, avoiding the injury of the brain tissues adjacent to the tumor as far as possible were the keys to increase the surgical outcome and improve the life quality. The pursuit of total tumor resection should be avoided.%目的 探讨中央沟区矢状窦旁脑膜瘤的显微手术治疗方法及效果.方法 回顾性分析32例采用显微手术切除的中央沟区矢状窦旁脑膜瘤病人的临床资料.结果 SimpsonⅠ级切除3例, SimpsonⅡ级切除15例, SimpsonⅣ级切除14例.无手术死亡病例.无新增癫疒间发作.术后运动障碍改善14例, 感觉障碍改善9例.严重脑水肿和梗死1例, 去骨瓣加压术后恢复良好.随访6个月＜sup＞7＜/sup＞年, 平均45个月, 复发6例 (SimpsonⅡ级切除2例和Ⅳ级切除4例) , 其中2例再次手术治疗.结论 术前充分评估, 术中合理处理回流静脉、中央沟静脉和上矢状窦, 尽可能避免毗邻脑组织的再损伤是提高手术效果和改善生活质量的重要手段, 不应过分追求肿瘤全切.
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