Ostreiko O.V., Ulitin A.Yu.
(Polenov Research Neurosurgical Institute)
Female patient A., aged 45, was admitted to the Department of Brain and Spinal Cord Tumors Surgery on October 17, 2000.
On admission she complained of headache, accompanied by nausea, narrowing of a visual field margin on the left. The patient fell ill three years ago. Tumor was identified during MRI examination for mild craniocerebral trauma. Neurologic symptoms included hypertension syndrome with initial manifestations of engorged disks, total left-sided homonymous hemianopsia, mild left-sided pyramidal insufficiency. MRI showed tumor of the posterior third of the falciform process with bilateral spread (mainly to the right), distinct borders and dimensions of 6.6 x 6.3 x 5.6 cm.
There were two stages of surgical treatment. The first stage (23.10.2000) consisted in osteoplastic trephination in the occipitoparietal area, made on both sides (mainly on the right), mobilization of a bone graft. The second stage (16.11.2000) included repeated osteoplastic trephination in the occipitoparietal area, removal of meningioma of the posterior third of the falciform process with bilateral spread, described above (Prof. Tigliev G.S.).
There were no complications in a postoperative period. The wound healed by first intention. The patient informed about widening of visual fields on the second day after the operation. Neuroophthalmologic examination was indicative of widening of the left visual fields by 40 degrees. The patient was discharged after removal of sutures in a satisfactory state.
To discuss the nearest result of surgical treatment of giant meningioma of the posterior third of the falciform process, resulting in good restoration of visual functions.