Skip to main content
main-content

01.09.2009 | Technique Applications | Ausgabe 9/2009

Acta Neurochirurgica 9/2009

Navigated resection of giant intracranial meningiomas based on intraoperative 3D ultrasound

Zeitschrift:
Acta Neurochirurgica > Ausgabe 9/2009
Autoren:
Ole Solheim, Tormod Selbekk, Frank Lindseth, Geirmund Unsgård

Abstract

Background

Surgical resection of giant meningiomas may pose different challenges. Normal brain tissue is often compressed to the limit and is vulnerable to further traction. In addition, severe intraoperative bleeding may be a problem as many giant meningiomas are vascularised with deep feeding vessels entering from the skull base. Neuronavigation based on preoperative imaging can be of limited use as there may be extensive brain shifts during surgery.

Method

We have retrospectively evaluated navigated resection based on intraoperative 3D ultrasound in a series of 15 giant meningiomas with a diameter of more than 5 cm. A pre- and postoperative MRI was preformed in all patients. Preoperative and postoperative neurological function was assessed.

Findings

We were able to safely perform ultrasound-guided intracapsular gross total resection of tumour tissue in all patients. Twelve out of 15 patients were radically operated (Simpson grade I and II). Major feeding arteries and adjacent normal arteries could be identified by ultrasound power Doppler angiography. In one patient we were not able to indentify important venous structures. All patients experienced postoperative improvement of their symptoms. Postoperative MRIs did not reveal significant ischemic changes in adjacent normal brain tissue. The mean duration of hospitalisation after surgery was 4.9 days.

Conclusion

We present a method of ultrasound-guided resection of giant meningiomas. The method enables image-guided resection through narrow approaches that minimise traction. Power Doppler angiography allows the identification of feeding vessels that may be coagulated to limit bleeding. Likewise, normal arteries can be avoided during surgery. The tumour capsule is often surprisingly easy to remove from the arachnoid membrane after gross intracapsular tumour reduction.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 9/2009

Acta Neurochirurgica 9/2009 Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

  2. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

  3. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise