[The application and mechanism analysis of postoperative intracranial pressure monitoring in giant meningioma(clinical analysis of 7 cases)].

OBJECTIVE: To investigate varying patterns of intracranial pressure(ICP)after giant meningioma resection and analyze the causes of the variation of ICP in different postoperative phases.

METHODS: Clinical data, surgical approachs and the ICP monitoring data of 7 patients with giant meningioma in different positions who were admitted to the First Affiliated Hospital of Soochow University from October 2013 to July 2014 and received microsurgical resection via different approachs were analysed retrospectively. The tumour locations were in convexity(n=1), olfactory groove(n=1), sphenoidal ridge(n=2), parasagittal(n=1), falx(n=1), petroclival(n=1) and resected via longitudinal fissure approach, subfrontal approach, extensive pterional approach, subtemporal approach. ICP monitoring probe was placed subdurally and average monitoring time was 9 days. Dehydrating agent was administered in all cases postoperatively.

RESULTS: Tumors were totally resected (Simpson Grade Ⅰ or Ⅱ ) in all patients. The increase of ICP was observed on the 3(rd) day, peaked on the 4(th) day and reduced to normal on the 5(th)-7(th) day. Decompressive craniectomy and tracheotomy were performed in one case due to consciousness deterioration, severe brain edema and continuous ICP augment on the third day after operation. All the patients recovered well except for the cerebrospinal fluid rhinorrhea occurring in one case postoperatively, whose symptom ameliorated significantly after conservative treatment.

CONCLUSION: ICP monitoring exerts an important role on the postoperative management of giant meningioma. Simultaneously, The summary of vast ICP monitoring data concerning to giant meningioma provides the evidence and experience for protecting neurological function via abundant preoperative preparations, reasonable operative approach, careful postoperative management.