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Academia Mexicana de Neurología, A.C.

2011, Número 1

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Rev Mex Neuroci 2011; 12 (1)


Meningiomas del proceso clinoideo anterior

Díaz CA, Zottis GC, Rehder R, Borba LAB

Idioma: Español
Referencias bibliográficas: 51
Paginas: 27-37
Archivo PDF: 661.94 Kb.


RESUMEN

Introducción: Los meningiomas que involucran al pro-ceso clinoideo anterior son los más problemáticos detodos los del ala esfenoidal, por su relación con es-tructuras vasculares y nerviosas importantes. Son losque tienen una tasa mayor de morbilidad y derecurrencia, junto con los meningiomas del clivus. Objetivo: Analizar vía de acceso, extensión de la resec-ción ósea, resultados y complicaciones. Método: Serevisó el expediente clínico de 15 pacientes con eldiagnóstico de meningioma del proceso clinoideoanterior, manejados quirúrgicamente en el HospitalUniversitario Evangelico de Curitiba, durante el perio-do comprendido del 2000-2010. Resultados: En todoslos pacientes el abordaje empleado fue craniotomíaorbitozigomática, en 12 casos se realizó una remociónradical y en tres casos una remoción parcial, dentrode las complicaciones las más frecuentes: déficit del IIInervio craneal (cuatro casos), déficit motor (dos ca-sos), fístula de líquido cerebroespinal (dos casos) y dolorfacial (un caso). La función visual mejoró en ochopacientes, en cinco casos no se modificó y empeoróen dos pacientes. Conclusión: Con el uso de técnicasde cirugía de la base del cráneo es posible realizarla resección radical, que incluye la exéresis tumoraly la parte ósea, con uno o más abordajes combina- dos, siendo la primera cirugía la mayor oportunidadde realizar una resección radical sin incrementar lamorbilidad y con menor riesgo de recurrencia.


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