Predictability of internal carotid artery (ICA)dissectability in cases showing ICA involvement in parasellar meningioma

Ishikawa, Masatsune; Nishi, Shogo; Aoki, Tomokazu; Takase, Takashi; Wada, Eiki; Oowaki, Hisayuski; Katsuki, Takahisa; Fukuda, Hitoshi

doi:10.1054/jocn.2001.0872

Cited by 18 publications

(11 citation statements)

References 2 publications

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“…16,18,22,23,25,31 In all 12 of our cases, the ICA was completely encased. The MCA was also encased in all 12 cases, in 9 of them completely and in the 3 others partially.…”

Section: Discussionmentioning

confidence: 54%

Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries

Champagne¹,

Lemoine²,

Bojanowski³

2018

Neurosurgical Focus

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OBJECTIVESphenoid wing meningiomas are a heterogeneous group of tumors with variable surgical risks and prognosis. Those that have grown to a very large size, encasing the major cerebral arteries, are associated with a high risk of stroke. In reviewing the authors’ series of giant sphenoid wing meningiomas, the goal was to evaluate how the extent of the tumor’s invasion of surrounding structures affected the ability to safely remove the tumor and restore function.METHODSThe authors conducted a retrospective study of a series of giant sphenoid wing meningiomas operated on between 1996 and 2016. Inclusion criteria were meningiomas with a globoid component ≥ 6 cm, encasing at least 1 major intradural cerebral artery. Extent of resection was measured according to Simpson grade.RESULTSThis series included 12 patients, with a mean age of 59 years. Visual symptoms were the most common clinical presentation. There was complete or partial encasement of all 3 major cerebral arteries except for 3 cases in which only the anterior cerebral artery was not involved. The lateral wall of the cavernous sinus was invaded in 8 cases (67%) and the optic canal in 6 (50%). Complete resection was achieved in 2 cases (Simpson grades 2 and 3). In the remaining 10 cases of partial resection (Simpson grade 4), radical removal (> 90%) was achieved in 7 cases (70%). In the immediate postoperative period, there were no deaths. Four of 9 patients with visual deficits improved, while the 5 others remained unchanged. Two patients experienced transient neurological deficits. Other than an asymptomatic lacuna of the internal capsule, there were no ischemic lesions following surgery. Tumor recurrence occurred in 5 patients, between 24 and 168 months (mean 61 months) following surgery.CONCLUSIONSAlthough these giant lesions encasing major cerebral arteries are particularly treacherous for surgery, this series demonstrates that it is possible to safely achieve radical removal and at times even gross-total resection. However, the risk of recurrence remains high and larger studies are needed to see if and how improvement can be achieved, whether in surgical technique or technological advances, and by determining the timing and modality of adjuvant radiation therapy.

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“…16,18,22,23,25,31 In all 12 of our cases, the ICA was completely encased. The MCA was also encased in all 12 cases, in 9 of them completely and in the 3 others partially.…”

Section: Discussionmentioning

confidence: 54%

Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries

Champagne¹,

Lemoine²,

Bojanowski³

2018

Neurosurgical Focus

View full text Add to dashboard Cite

show abstract

“…The occurrence of stroke in patients with a brain tumor has been described, vascular occlusion is related to either direct compression or vascular infiltration by the tumor, or indirectly by coagulation disorders [4,5]. Meningiomas are the most common benign tumors in adults, and the para sagittal, fronto-basal or skull base localizationare usual as our patient [6,7]. By their location few cases of transient ischemic injury have been reported, Komotar et al [8] estimated to 0.19% the incidence of meningioma related cerebral ischemia by carotid artery compression.…”

Section: Discussionmentioning

confidence: 65%

Anterior Cerebral Infarction by Fronto-Basal Meningioma

Ossou-Nguıet¹,

Gnonlonfoun²,

Obondzo-Aloba³

et al. 2013

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The association between stroke and meningioma is rarely reported in the data. In most etiology classification, there is no compressive cause. The association between meningioma and stroke is increasingly reported. We report a case of 52year-old woman, previously healthy, presented with sudden right hemiplegia with some transient mood disorders. The CT-scan revealed acute left anterior cerebral artery infarction associated with fronto-basale meningioma infiltrating both anterior cerebral arteries. She was treated by corticosteroid and rehabilitation, with partial recovery. No stroke prevention was used before surgical treatment.

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“…Surgery of medial sphenoid wing meningiomas can be associated with significant nervous and vascular complications (morbidity rate 18%) 2 . Severe stenosis of ICA and/or its branches, related to elongation, encasement or invasion by the meningioma, is thought to be predictive of a poor surgical outcome 3 . Although encasement of the ICA by a skull base meningioma is not rare, stroke related to this encasement is very rare.…”

Section: Resultsmentioning

confidence: 99%

Endovascular Angioplasty before Resection of a Sphenoidal Meningioma with Vascular Encasement

et al. 2011

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We describe a case of sphenoid wing meningioma presenting with cerebral infarction due to extended vascular encasement in which endovascular angioplasty was performed before surgery to avoid perioperative ischemia. A severe stenosis involved the intracranial internal carotid artery and the proximal segments of the middle and anterior cerebral arteries. Endovascular dilatation was followed by complete surgical resection. Preoperative mild aphasia and hemiparesia resolved completely after surgery. Endovascular angioplasty of arterial trunks and their branches can be proposed before the resection of skull base meningiomas encasing these arteries to decrease the risk of perioperative brain ischemia related to their surgical manipulation or vasospasm.

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Predictability of internal carotid artery (ICA)dissectability in cases showing ICA involvement in parasellar meningioma

Cited by 18 publications

References 2 publications

Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries

Surgical management of giant sphenoid wing meningiomas encasing major cerebral arteries

Anterior Cerebral Infarction by Fronto-Basal Meningioma

Endovascular Angioplasty before Resection of a Sphenoidal Meningioma with Vascular Encasement

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