Posterior fossa meningiomas: surgical experience in 161 cases

Roberti, Fabio; Sekhar, Laligam N.; Kalavakonda, Chandrasekar; Wright, Donald C.

doi:10.1016/s0090-3019(01)00479-7

Cited by 215 publications

(149 citation statements)

References 45 publications

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“…Primary jugular foramen meningiomas are extremely rare, accounting for approximately 0.7-4% of all posterior fossa meningiomas, and 9-10% of all intracranial meningiomas. 1,12,14) The number of case reports has been increasing. This review evaluated the cases of 96 patients previously described to assess the clinical characteristics of jugular foramen meningiomas, and to propose a staging system for these meningiomas.…”

Section: Introductionmentioning

confidence: 99%

Jugular Foramen Meningiomas: Review of the Major Surgical Series

Bakar

2010

Neurol. Med. Chir.(Tokyo)

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Primary jugular foramen meningiomas are uncommon, with 96 previous cases published between 1992 and 2007. Exact location and extent of tumor were determined on the basis of radiologic and operative findings and used to develop a staging system. The mean age of patients was 39.4 years. The lesion was located on the right in 14 patients and on the left in 11 patients. The series identified 23 males and 58 females. The most common presenting clinical symptoms were hearing loss and tinnitus. Most clinical findings were middle ear mass and neck mass. Most meningiomas were World Health Organization grade I. The most common postoperative complications were lower cranial nerve paresis and facial nerve paresis. Surgical planning should consider that meningiomas usually invade the dura mater, cranial nerves, and surrounding bone. The surgeon should carefully collect detailed data about the tumor, and consult an otolaryngologist preoperatively for lower cranial nerve functions and hearing levels.

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Section: Introductionmentioning

confidence: 99%

Jugular Foramen Meningiomas: Review of the Major Surgical Series

Bakar

2010

Neurol. Med. Chir.(Tokyo)

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“…In our series, recurrent tumors after total and gross total resection occurred in no patient. Recurrence rates of 12.5%, 7) 14.2%, 14) and 21% 9) have been reported. Among patients with subtotal/partial resection and residual tumor, 13.3% showed disease progression, and in two of these four cases recurrent tumors developed from remnant tumor within the cavernous sinus, confirming this anatomical region as a likely site for recurrence/progression of tumor.…”

Section: Tumor Resection and Separation From Neurovascular Structmentioning

confidence: 98%

“…As previously reported, preoperative embolization enabled us to control bleeding from the tumor and safely perform tumor removal as extensively as possible. 14) Intraoperative management of all posterior cranial base meningiomas requires that the patient's head must be slightly elevated to facilitate cerebral venous drainage. The head should be inclined toward the floor to allow gravity to pull the temporal lobe or cerebellum away.…”

Section: T Matsuimentioning

confidence: 99%

“…The head should be inclined toward the floor to allow gravity to pull the temporal lobe or cerebellum away. 14) The approach and craniotomy varies according to the type of meningioma.…”

Section: T Matsuimentioning

confidence: 99%

“…Among all intracranial meningiomas, those arising from the posterior cranial fossa account for 9-10%. 10,14,21) In early series, surgical attempts to remove these lesions were associated with high rates of morbidity and mortality 6,12) and some petroclival meningiomas were defined as``inoperable. '' 12) With the introduction of high resolution computed tomography (CT) and magnetic resonance (MR) imaging, and the development of microsurgical techniques and cranial base approaches, the surgical management of these tumors has been evolving, leading to better outcome and marked reduction in surgical morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic Strategy and Long-term Outcome of Meningiomas Located in the Posterior Cranial Fossa

Matsui

2012

Neurol. Med. Chir.(Tokyo)

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The clinical and surgical findings of 41 consecutive cases of posterior cranial fossa meningiomas operated on between January 1987 and December 2011 at Saitama Medical Center/Saitama Medical University were reviewed. The 31 female and 10 male patients were aged from 19 to 74 years (mean 54 years). The tumors were located in the petroclival (N ＝ 15), craniovertebral junction (N ＝ 6), lateral tentorial (N ＝ 12), and cerebellopontine angle (N ＝ 8) regions. Mean tumor equivalent diameter was 4.3 cm (range 2-9 cm). Head pain (46.3%) and gait disturbance (26.8%) were the most common presenting symptoms, and cranial neuropathies were the most common neurological signs on admission. Mean preoperative performance status (Karnofsky scale) was 83% (range 40-100%). Surgical approaches to these tumors included presigmoidal transpetrosal, retrosigmoidal, transcondylar, and combined approaches. In 4 cases, a staged procedure was performed. Gross total resection was achieved in 85.4% of patients, and subtotal/partial resection in 12.2%. Surgical mortality was 2.4% and complications were encountered in 11 patients (26.8%) including temporary neurological deficits in 4 patients. The mean follow-up period was 8.2 years, ranging from 1 to 24 years, and the mean performance status of patients at 12 months after the last surgery was 92% (range 0-100%). Recurrence or progression of disease was found in 9.8% of cases. Postoperative adjuvant therapy was performed in 6 cases. My experience suggests that although posterior cranial fossa meningiomas represent a continuing challenge for contemporary neurosurgeons, such tumors may be completely or subtotally removed with low rate of mortality and acceptable morbidity, allowing most of these patients to achieve good outcome in long-term follow up.

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