Abstract: Objective To investigate the clinical efficacy of microsurgery in the resection of giant para-sagittal meningioma in the elderly. Methods The clinical data of 32 elderly patients with giant meningioma(diameter >5 cm)involving the cortex of the functional area treated with microsurgery in our hospital during Jan. 2014 and Aug. 2018 were retrospectively analyzed. The patients aged >60 years(mean 63.4±2.5 years, maximum 78 years). The clinical outcomes and surgical skills were summarized. Results Hypertension was detected in 11 cases, coronary heart disease in 5 cases, diabetes mellitus in 8 cases, intracranial vascular stenosis in 4 cases, syringomyelia in 2 cases, and 2 cases had no complications. Motor/sensory evoked potentials were monitored throughout the operation. Simpson I resection was performed in 11 cases, Simpson II resection in 9 cases(2 cases were recurrent meningioma), Simpson III resections in 9 cases(3 cases were recurrent meningioma), and Simpson IV resection in 3 cases(2 cases were recurrent meningioma). Patients with WHO II tumor, WHO III tumor, residual tumor, or meningioma with active proliferative tumor cells received radiotherapy after operation. During the follow-up of 4-43 months, 1 case had relapse in month 11 and recov- 山 东 大 学 学 报 (医 学 版)57卷11期 -田海龙,等.老年功能区矢状窦旁巨大脑膜瘤的显微手术治疗 \=-ered after a second operation and adjuvant radiotherapy. In no-death cases during operation, 14 manifested with hemiplegia and hemidysesthesia, in which 12 recovered; 3 cases developed hemiplegia, 1 of which was complicated with pneumonia, and recovered after 7-21 days; 8 patients with epilepsy took antiepileptic drugs and no seizure recurred. Conclusion In the microsurgical excision of giant para-sagittal meningioma in elderly patients, the protection of cortex and drainage veins in functional area is very important. As the complications affect clinical outcomes, due attention should be paid to the perioperative comorbidities and complications.

Key words: Para-sagittal meningioma, Functional area, Elderly