Mihai Stelian Moreanu & Marina Cozma
University of Medicine and Pharmacy “Carol Davilaâ€, Romania
Title: Establishing the proper approach to an effective surgical treatment for the Meningioma
Biography
Biography: Mihai Stelian Moreanu & Marina Cozma
Abstract
Meningiomas are benign extra-axial tumors, originating from the meningeal arachnoidal cells, making up 20% of the intracranial
primary tumors. Surgical management of meningiomas is one of the most challenging procedures posing a high risk of affecting
the critical neurovascular centers of the brain. This paper attempts to identify the way Para clinical brain investigations coupled with a
well-established surgical procedure lead to an efficient and strategic treatment of meningioma, starting with a real case of a 50-year-old
woman. The clinical background of the patient was represented by frontal headaches, rare epileptic crisis, sudden dizziness, blurry vision,
loss of equilibrium and exhaustion. The Para clinical investigation included contrast MRI showing a homogenous irregular expanding
tumor process in the frontal-orbital left space. Localization, depth, diameters were also shown on MRI. Moreover, Digital Angiography
was used to identify the source of vascularization, highlighting a slight displacement of the arterial irrigation of Willis Polygon towards
the tumoral process. These symptoms and investigations led to diagnosing a sphenoid left wing meningioma. The treatment was mainly
focused on the neurosurgical intervention, having several purposes: rejecting the meningioma, establishing the anatomo pathological
diagnosis, developing the therapeutic plan. The surgical procedure included the following steps: positioning, incision, craniotomy,
tumor exposure, devascularization, decompression, extra capsular dissection, tumor removal, closure. The surgical approach was on
the frontotemporal side and after a step-by-step incision, the tumor was exposed. The excision strategy was focused on fragmentation
and mild dissection of the surrounding brain tissue. Also, while the tumor surface coagulated constantly, it lost volume and allowed an
easy dissection. The final result was favorable – the patient regained her balance. Getting a better understanding of the neurosurgical
steps of treating meningiomas will lead to finding strategies that will improve the patient's treatment and his quality of life.