CLINICAL, SURGICAL AND REHABILITATION ASPECTS OF MENINGIOMAS OF THE POSTERIOR CRANIAL FOSSA
Meningiomas account for 37.6 % of all primary CNS tumors and 53.3 % of all benign CNS tumors. Dysfunction of the cranial nerves, cerebellar symptomatology, sometimes aggravated after removal of the tumor and require rehabilitation treatment.PURPOSE OF THE STUDY: to evaluate the results of surgical and rehabilitation treatment of meningiomas of the posterior cranial fossa, taking into account the clinical and neurological manifestations, the volume and localization of the tumor, the degree of tumor resection. MATERIALS AND METHODS: The results of clinical examination, surgical treatment and rehabilitation of 66 patients with meningiomas of the posterior cranial fossa who were treated at the Department of Brain and Spinal Cord Tumor Surgery of the N. N. prof. A. L. Polenov for the last 3 years. Localization of meningiomas: 27 (41 %) - the posterior edge of the temporal bone pyramid, 8 (12 %) - the apex of the temporal bone pyramid, 15 (23 %) - the tentorium of the cerebellum, 9 (14 %) - the area of the greater foramen magnum, 6 (9 %)) - petroclival, 1 (2 %) - region of the cerebellar hemisphere. RESULTS. All patients underwent surgical treatment: 42 (63.6 %) observations - total tumor removal, 17 (25.8 %) - subtotal, 6 (9.1 %) - partial, in 1 (1.5 %) case only biopsy of the meningioma of the greater foramen magnum, due to the involvement of the vertebral artery into the stroma of the tumor. After the rehabilitation treatment, a significant improvement in the state of the ICF domains was obtained: walking, self-care, dizziness. CONCLUSION. In most cases, meningiomas of the posterior cranial fossa can be removed totally without increasing neurological symptoms. In the event of a neurological deficit after tumor removal, rehabilitation treatment carried out in the early postoperative period can significantly reduce clinical symptoms and further continue treatment in rehabilitation centers. If the meningiomas are partially removed, it is recommended to carry out radiation therapy or stereotaxic radiosurgical treatment of the remaining part of the tumor. Patients after removal of benign brain tumors have a high rehabilitation potential, regardless of the location and degree of radicality of the neoplasm. Rehabilitation treatment is most advisable as early as possible from the moment of surgical removal of the tumor.