Complex Treatment of Patients with Parasagittal Meningiomas
Abstract
In the English-language literature, parasagittal (PSM) meningiomas associated with the superior sagittal sinus (SCS) are called, most Russian authors include tumors associated only with the crescent of the brain in this group.The issue was considered in detail in the publication of the fourth author [1][2][3], in this study we consider only SCC meningiomas as more difficult for radical removal.Meningiomas are the most common primary CNS tumors (37.2%), their incidence is 8.33 per 100,000 population per year [4,5].The proportion of SCI among all meningiomas has not been specified, since the exact localization of the meningeal tumor is not taken into account in existing registries, and publications reflect the material of specific clinics, and even within the same clinic, the ratio may change over time [6][7][8][9].Based on our experience at the end of the last century, it can be assumed that SCI account for approximately 28% of intracranial meningiomas [10,11] and their incidence is 2.33 per 100,000 population per year, i.e. exceeds the incidence of tumors of the cranial and spinal nerves (1.89 per 100,000 population per year) [12].In addition to a fairly high incidence rate, the relevance of the problem of SCI is due to the complexity of topographic and anatomical relationships in the parasagittal region and, first of all, the presence of critically significant venous structures there.An increase in the radicality of the operation due to reconstructive interventions on the SCD, according to our data, is accompanied by a twofold increase in morbidity [14-18], and, according to the literature [19], and deaths.A reasonable restriction of radicality provides better functional results, but increases the risk of tumor recurrence, ranging from 25% [20,21] to 62% [22][23][24].In recent decades, methods of stereotactic radiosurgery and radiation therapy have been developed and put into practice , providing comparable results.However, since neurosurgery and radiation treatment are performed by representatives of different medical specialties, many publications lack a full comparison of the advantages and disadvantages of surgical and radiation methods.There is no recognized algorithm for choosing the optimal method of complex treatment of patients with SCI.