脑实质内或皮层下脑膜瘤的临床特点

Clinical features of intraparenchymal and/or subcortical meningioma

摘要:

目的：探讨脑实质内脑膜瘤（Intraparenchymal meningioma）或皮层下脑膜瘤（Subcortical meningioma）的发病规律、发生机理、诊断及治疗。方法：回顾性分析了我们治疗的2例及SCI、Medline收录文献中报道的17例脑实质内或皮层下脑膜瘤。结果：19例脑实质内或皮层下脑膜瘤中，男8例，女11例，男女之比为1：1.38；年龄最小1岁，最大73岁，中位数为17岁。首发症状癫痫10例（占52.6%），头痛5例（占26.3%）。除2例没有CT或MRI检查外，17例脑实质内或皮层下脑膜瘤中有7例为囊性脑膜瘤，占41.2%，周围伴有明显水肿者12例，占70.6%，伴有钙化者3例，占17.6%。组织学检查显示WHOI级脑膜瘤15例，占78.9%，其中11例为纤维型，占73.3%。WHOⅡ级脑膜瘤3例，占15.8%，WHOⅢ级脑膜瘤1例，占5.3%。结论：脑实质内或皮层下脑膜瘤男性发生率高于一般脑膜瘤，发病年龄较小，最常见的首发症状为癫痫，囊性脑膜瘤发生率高，WHOⅠ级脑膜瘤中绝大多数为纤维型，WHOⅡ、Ⅲ级脑膜瘤发生率高于一般脑膜瘤。

Abstract:

Objective: To investigate the epidemiologic peculiarity,clinical presentations,radiological features and pathological factors of intraparenchymal and/or subcortical meningiomas.Methods: The authors retrospectively studied two patients with intraparenchymal meningiomas operated in recent years and reviewed 17 patients with intraparenchymal and/or subcortical meningiomas reported in the literature.Results: In the 19 cases,eight patients were male and eleven were female.The male to female ratio was 1:1.38.The age of the 19 cases ranged from 1 to 73 years,and the median age was 17 years.The initial symptoms of the 19 cases were predominantly epilepsies(52.6%),and next to it were headaches(26.3%).Except for two cases due to lack of the data of CT and MRI,seven(41.2%) were cystic meningiomas,twelve(70.6%) displayed peritumoral edema,and three(17.6%) were accompanied with calcification among the other 17 cases of intraparenchymal and/or subcortical meningiomas.Out of the 19 cases,WHO gradeⅠmade up 78.9%(15 cases),WHO grade Ⅱ 15.8%(three cases) and WHO grade Ⅲ 5.3%(one case).Most of WHO grade I intraparenchymal and/or subcortical meningiomas were fibroblastic,which made up 73.3%.Conclusions: Compared with the common meningioma,intraparenchymal and/or subcortical meningioma is more often occurring in male,and at younger age.The initial symptom is predominantly epilepsies.The incidence of cysts and WHO gradeⅡand Ⅲ meningiomas is higher.The most of WHO gradeⅠintraparenchymal and/or subcortical meningiomas were fibroblastic,a sharp different from common meningiomas.