儿童脑膜瘤的临床特点及治疗：附12例报告并文献复习。

探讨小儿脑膜瘤的临床特点及治疗方法。

回顾性分析了186例儿童脑膜瘤的性别、年龄分布、症状、体征、影像学及病理学表现、治疗及预后，其中齐鲁医院收治12例，文献报道8例。

男孩和女孩的比例是2.3:1。年龄0.5～15岁，平均9.9岁。颅神经紊乱（28%）和慢性颅内压增高症状如头痛（62%）、呕吐（53%）和乳头水肿（55%）是最常见的症状。最常见的部位是脑凸（41%），其次是脑室（15%）、鞍区（8%）、桥小脑角（8%）、脑实质内瘤（5%）、矢状窦旁区（4%）等，密度均匀者占62.3%，钙化者占14.8%，囊性成分占21.3%，瘤内出血占1.6%。上皮型和纤维母细胞型脑膜瘤平均占55%，恶性或非典型脑膜瘤平均占9%。肿瘤完全切除率74%，术后死亡率3.3%。

与成人脑膜瘤相比，儿童脑膜瘤主要发生在男性，癫痫发病率较低，且常伴有多发性神经纤维瘤病。儿童脑膜瘤的预后比成人差。肿瘤初次切除程度、肿瘤部位、病理分级及与神经纤维瘤病的关系是影响患者预后的重要因素。

To study the clinical characteristics and treatment of meningiomas in children.

One hundred and sixty-six meningiomas in children, including 12 cases treated in Qilu hospital and 8 series reported in the literature, were analyzed retrospectively on sex, age distribution, presenting symptoms, signs, radiological and pathological findings, treatment and prognosis.

The ratio of boys and girls was 2.3:1. The age ranged from 0.5 to 15 years (mean 9.9 years). Cranial nerve disorder (28%) and signs of chronic increased intracranial pressure such as headaches (62%), vomiting (53%) and papilledema (55%) were the most common symptoms. The most common location was the cerebral convexity (41%), followed by ventricles (15%), saddle areas (8%), cerebellopontine angles (8%), brain intraparenchyma (5%), parasagittal regions (4%), etc. Homogeneous density was observed in 62.3% of all cases, calcification in 14.8%, cystic components in 21.3% and intratumoral hemorrhage in 1.6%. On average, the epithelial and fibroblastic types of meningiomas took up 55% of the case, while the amount of malignant or atypical meningiomas averaged 9%. Complete tumor excision was achieved in 74%, and postoperative mortality was 3.3%.

Compared with meningiomas in adults, meningiomas in children occur predominantly in males with a lower incidence rate of epilepsy, and are frequently associated with multiple neurofibromatosis. Meningiomas in children have a poorer prognosis than those in adults. Degree of the first tumor resection, tumor location, pathological grade and association with neurofibromatosis are the most important factors influencing the patients' prognoses.