目的 :探索小脑幕脑膜瘤的手术入路和手术效果。方法 :通过显微外科手术治疗 2 1例小脑幕脑膜瘤 ,根据肿瘤的生长方式和MRI的表现分为四种类型 :Ⅰ型 :小脑幕切迹外侧缘近岩骨尖 ,向中颅窝、海绵窦、上斜坡生长 7例 ;Ⅱ型 :小脑幕切迹后内侧缘及镰幕交界处 3例 ;Ⅲ型 :起源于小脑幕向CPA生长 6例 ;Ⅳ型 :小脑幕的其他部位 ,包括基底位于横窦、岩上窦及其骑跨型肿瘤 5例。颞枕开颅颞下小脑幕入路切除Ⅰ型 (主要向中颅窝生长 )肿瘤 3例 ;颞枕开颅乙状窦前入路切除Ⅰ型 (主要向中上斜坡生长 )肿瘤 4例 ;Poppen入路切除Ⅱ型肿瘤 3例 ;CPA开颅乙状窦后入路切除肿瘤 7例 ;幕上下联合开颅切除骑跨型肿瘤 3例 ;幕下小脑上入路切除肿瘤 1例。结果 :按脑膜瘤切除Simpson分级 :Ⅰ级切除 4例 ;Ⅱ级切除 8例 ;Ⅲ级切除 9例。结论 :Ⅰ型肿瘤可用颞下经小脑幕或乙状窦前入路获得较高的切除率 ;Poppen’s入路对Ⅱ型肿瘤有较好的暴露及获得良好的切除 ;Ⅲ型全切除常易损伤颅神经 ;Ⅳ型肿瘤大多可全切除 Objective: To explore the surgical approach and operation effect of cerebellar meningioma. Methods: Twenty-one cases of cerebellar meningiomas were treated with microsurgery. According to the growth pattern of tumors and MRI findings, they were divided into four types: Type I: the lateral petrosal bone near the lateral margin of the notch of the cerebellum, Cavernous sinus, the growth of the slope on the 7 cases; type II: the lateral margin of the cerebellar notch and the sickle curtain junction in 3 cases; type Ⅲ: originated in the cerebellar to the CPA growth in 6 cases; type Ⅳ: other parts of the tentorium including The basal is located in the transverse sinus, petrous sinus and its riding type tumors in 5 cases. Three cases of type Ⅰ tumors (mainly to the middle cranial fossa) were excised from the inferior temporal cephalamic tentorium by temporal occipital craniotomy. Four cases of type Ⅰ tumors (mainly upper-middle slope growth) Poppen approach resection of type Ⅱ tumor in 3 cases; CPA open the sigmoid sinus retrograde approach to remove the tumor in 7 cases; supratentorial combined craniotomy resection of riding-type tumor in 3 cases; supratentorial cerebellar approach to remove the tumor in 1 case. Results: According to the Simpson classification of meningioma, grade Ⅰ was removed in 4 cases, grade Ⅱ was removed in 8 cases and grade Ⅲ was removed in 9 cases. Conclusion: The type Ⅰ tumor can be obtained by superior temporal subtotal or sigmoid anterior approach to obtain a high resection rate; Poppen’s approach for type Ⅱ tumors have a good exposure and good removal; type Ⅲ total resection often damage Cranial nerve; most of type IV tumors can be removed