医学英语学习7 Ca7: Medial sphenoid wing meningiomaarpanet 沈阳会计A 64-year-old woman had suffered left-sided headache for 3 years. Shortly before hospitalization she experienced transient y spells with loss of consciousness. Two years earlier she had had an episode of speech impairment and paralysis of the right arm that resoved in a few minutes. Results of neurological examination were positive only for slight paresis of the right arm. CT scan showed a mass lesion that appeared to ari from the left medial sphenoid wing extending into the anterior and middle cranial fossa. The cerebral angiogram displayed upward deviation of the middle cerebral artery with displacement of the anterior cerebral artery and vascular pattern typical of meningloma. The tumor was expod through a left frontotemporal crani-otomy with a wide opening of the Sylvian fissure. The meningio-ma was reduced in size with the ultrasonic aspirator? and the heavily enmeshed middle cerebral artery was microsurgically freed of tumor. Additional tumor was removed along the cours of the middle cerebral artery, and the internal carotid artery, also enveloped by tumor, was isolated. It was then possible to completely remove the neoplasm along with its dural attachment on the inner sphenoid wing. The anterior cerebral artery and the slightly displaced left optic nerve were anatomically and functionally prerved. The wound was clod in standard fashion. The patient left the hospital 18 days after the surgery, neurologically intact. Postoperative CT scan showed total tumor removal. citizenship>手袋出格培训The major problem with a medial sphenoid wing meningioma of this type is its clo proximity to important structures, such as the internal carotid artery and its branches, the optic nerve, the oculomotor nerve, and possibly the other motor nerves of the eye. By following the surgical strategy described above,we were able to safely isolate the internal carotid artery, which was completely encad in tumor, along with functionally important adjacent structures. | 蝶骨嵴内侧脑膜瘤 羚羊的英文64岁女性，左侧头痛病史3年。入院前有短暂的发作性意识丧失数次。2年以前出现过一次短暂性言语功能障碍和右上肢瘫痪，数分钟后自行缓解。神经系统查体仅见右上肢力量减弱。CT复活节的由来扫描可见左侧蝶骨嵴内侧一占位性病变，向前中颅窝延伸。造影显示大脑中动脉上抬，大脑前动脉移位，以及典型的脑膜瘤血管影像。 采用额颞瓣开颅，充分打开外侧裂，充分暴露肿瘤。用超声吸引器清除部分肿瘤，使肿瘤组织缩小。然后仔细游离被包绕的大脑中动脉。沿大脑中动脉切除剩余的肿瘤，同时仔细剥离被包绕颈内动脉。然后尽可能切除与蝶骨小翼处硬脑膜粘连的肿瘤。大脑前动脉和轻微移位的左侧视神经解剖和功能保留。逐层关闭切口。18天后患者出院，无神经功能缺失术后CTmother s day示肿瘤全切。 对于此型蝶骨嵴内侧脑膜瘤，需要注意的是肿瘤临近重要结构，如颈内动脉及其分支，视神经，动眼神经以及其他眼球运动神经。遵循以上描述的策略，我们能够安全分离被完全包绕的颈内动脉及其临近的具有重要功能的结构。 |
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