Correalation between injury of draining veins around meningiomas in superficial middle cerebral vein areas and postoperative cognitive changes / 中国基层医药

ABSTRACT

Objective To explore the correalation between change of postoperative cognitive function and injury of the draining veins around meningiomas in superficial middle cerebral vein areas ,to discuss the importance and protection method of draining veins around meningiomas in order to guide the microneurosurgery .Methods From July 2013 to July 2017,the clinical data of 54 patients with superficial middle cerebral vein areas meningiomas (tumor group) in the Central Hospital of Guangdong Nongken were retrospectively analyzed .And 52 healthy volunteers were selected as the control group.The preoperative and postoperative cognitive function and meningiomas peritumoral edema(MPE) were assessed by the Montreal Cognitive Assessment ( MoCA) and CT／MRI.Results The scores of visuospatial and executive [(3.23 ±1.27)points],order[(2.52 ±1.27) points],memory[(2.20 ±1.14) points], attention[(4.71 ±0.97)points],language[(2.19 ±0.74)points],abstract [(1.43 ±0.63)points],location[(5.83 ± 0.42) points],total[(22.06 ±0.33) points] in the tumor group were significantly lower than those in the control group[(4.83 ±0.38)points,(3.0 ±0.02)points,(3.5 ±1.04)points,(5.98 ±0.14)points,(2.54 ±0.50) points, (1.88 ±0.38) points,(5.98 ±0.33) points,(27.83 ±0.16) points] ( t ＝4.504,6.116,9.338,2.782,4.509, 2.390,8.670,all P＜0.05).According to the injury of the draining veins around meningioma ,54 patients were divided into the two groups,43 cases in the no -injuried group,11 cases in the injuried group.There were no statistically significant differences between the no -injuried group and injuried group in all measurements before operation (all P＞0.05).Both no-injuried group and injuried group had decline in MoCA and increase in MPE at 5 days after surgery. Both no-injuried group and injuried group had rise in MoCA [(26.35 ±0.36)points vs.(22.00 ±0.67)points] and decrease in MPE[(23.95 ±4.34)cm3 vs (44.64 ±9.68) cm3 ] at 30 days after surgery ( t＝5.944,2.098,all P＜0.05).The MoCA[(22.59 ±0.31)points vs (26.35 ±0.36)points] was obviously increased and the MPE [(87.84 ± 12.78)cm3 vs.(23.95 ±4.34)cm3] was obviously increased in 30 days after operation in no-injuried group(t＝7.289, 5.014,all P＜0.05),but the injuried group had just the opposite.Conclusion Injury of the draining veins around meningiomas in superficial middle cerebral vein areas can lead to cognitive dysfunction and compromise the quality of postoperative life in patients,every effort should be undertaken to preserve the draining veins around meningioma .