Posterior Fossa Meningioma: Surgical Strategy

Saleh, Essam; Taibah, A; Achilli, Vittorio; Arístegui, Miguel; Mazzoni, Antonio; Sanna, Mario

doi:10.1055/s-2008-1058956

Cited by 26 publications

(19 citation statements)

References 24 publications

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“…At the present moment the majority of the authors recommend subtotal resection for old patients or when there are factors defying complete removal. [1819]…”

Section: Discussionmentioning

confidence: 99%

Posterior fossa meningioma "our experience" in 64 cases

et al. 2012

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Background:Posterior fossa meningiomas are 20% of all intracranial meningiomas. These are slow-growing tumors thus become large before presentation. Microsurgical resection is the treatment of choice for the majority of these lesions, but variable locations, large size at diagnosis, frequent encroachment of neural and vascular structures, and their potentially invasive behavior are some of the features of these tumors that make their resection challenging.Materials and Methods:We studied 64 cases of posterior fossa meningioma operated in last 6 years, and analysed the technical difficulties encountered during excision of these tumors. Postoperative complications and outcomes of these patients were also analysed.Results:Gross total excision was achieved in 72% cases. Partial excision or subtotal excision was more in petroclival, jugular foramen with extra cranial extension, tentorial with intrasinus extension and ventral foramen magnum. Postoperative complication in form of new or aggravation of existing neurological deficit was found in 33% cases and CSF leak in 12.5% cases. We encountered the recurrence of total 10 cases (16%) over mean follow-up of 4 years. Most of the recurrent cases were seen in petroclival and tentorial subgroups with partial or subtotal excision.Conclusion:Posterior fossa meningiomas are difficult to excise due to close relation to cranial nerves and vessels. Use of microscope, CUSA, intraoperative nerve monitor help in removal and preserving surrounding important anatomical structures. Although neurological deterioration is common postoperatively, recovery does occur completely after total removal thus increasing the recurrence free period and improving the outcome.

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“…At the present moment the majority of the authors recommend subtotal resection for old patients or when there are factors defying complete removal. [1819]…”

Section: Discussionmentioning

confidence: 99%

Posterior fossa meningioma "our experience" in 64 cases

et al. 2012

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“…Schwannomas are usually iso‐ or hypointense on T1‐weighted images and iso‐ or hyperintense on T2‐weighted images enhanced with gadolinium. Although schwannomas tend to compress the jugular bulb, paragangliomas and meningiomas tend to invade the vessel with intraluminal growth 25,26 …”

Section: Discussionmentioning

confidence: 99%

“…Although schwannomas tend to compress the jugular bulb, paragangliomas and meningiomas tend to invade the vessel with intraluminal growth. 25,26 Careful preoperative evaluation of the venous flow (by means of arteriovenous MR angiography or 4-vessel angiography) of the sigmoid sinuses, jugular bulbs, and jugular veins is of paramount importance in avoiding complications (i.e., benign intracranial hypertension and venous cerebral infarct) related to closure of the dominant venous drainage of the brain. Angiography shows a mild arterial blush in meningiomas in contrast with a marked hypervascularity seen in paragangliomas.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Jugular Foramen Meningiomas: A Series of 13 Cases and Review of the Literature

et al. 2007

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“…Nowadays, 2 principal approaches are being adopted to remove PPFMs irrespective to the tumor location and size: the translabyrinthine approach (3,16,17) (which is mainly used in patients in which hearing is unserviceable) and the retrosigmoid approach (4,16,18Y22), with the latter being preferred by many.…”

Section: Discussionmentioning

confidence: 99%

Petrous Apex Mucocele

Sanna

Bacciu²,

Pasanisi³

et al. 2008

Otology &Amp; Neurotology

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Total tumor removal (Simpson Grades I-II) remains our treatment of choice and takes priority over hearing preservation. Subtotal resection is indicated for older and debilitated patients with giant lesions to relieve the tumor compression on the cerebellum and brainstem. Subtotal removal is also preferred in the face of the absence of a plane of cleavage between the tumor and the brainstem, in the presence of encasement of vital neurovascular structures, in elderly patients with tumors adherent to preoperatively normal facial or lower cranial nerves.

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Posterior Fossa Meningioma: Surgical Strategy

Cited by 26 publications

References 24 publications

Posterior fossa meningioma "our experience" in 64 cases

Posterior fossa meningioma "our experience" in 64 cases

Surgical Management of Jugular Foramen Meningiomas: A Series of 13 Cases and Review of the Literature

Petrous Apex Mucocele

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