Tuberculum sellae meningiomas: functional outcome in a consecutive series treated microsurgically

Tuberculum sellae meningiomas: surgical considerations

“…Two patients had lesions involving arteries, one patient had a lesion that invaded the pituitary stalk, and one patient had a tumor involving both optic nerves. The extension of tumoral resection according to Simpson I and II classification varies from 62% to over 90% 5,[17][18][19][20] and, gen- erally, depends on the consistency of the tumor, vascular encasement, tumor size, and clinical condition of the patients 17,19 . Large tumors seem to be a crucial factor for prediction of surgical outcome 17,19 .…”

“…Margalit et al 11 reported a case of stroke secondary to supraclinoid ICA occlusion. Bassiouni et al 18 described a patient who presented bilateral deterioration of visual acuity after injury of one segment of the ACA and another patient who suffered a stroke in the dominant hemisphere and whose ICA was lacerated and had to be clipped. The risk of lesion to the arteries involved by the tumor is higher in patients with hard tumors.…”

Stereotactic Radiosurgery for Skull Base Meningioma

“…3) The standard treatment for meningioma is surgical resection through craniotomy, targeted at gross total removal. 2,4,6,9,16,23,24,31,35) The treatment goal is longterm tumor control with minimal neurological morbidity. However, the tumor often extends to important neurovascular structures in the skull base, so total tumor resection (Simpson grades 1-2) is achieved in only 20-87.5% of patients.…”

“…However, the tumor often extends to important neurovascular structures in the skull base, so total tumor resection (Simpson grades 1-2) is achieved in only 20-87.5% of patients. 2,4,23,24,31,35) Unacceptably high incidences of symptomatic recurrence are observed after subtotal resection of meningiomas. 20,33) In addition, postoperative complications occur in 16.1-61.5% of patients, although overall complication rates are not always reported.…”

“…20,33) In addition, postoperative complications occur in 16.1-61.5% of patients, although overall complication rates are not always reported. 2,23,31,35) Stereotactic radiosurgery has now become a less invasive and effective treatment option for intracranial meningioma, especially in patients with high-risk tumors such as skull base lesions. 1,[11][12][13][14][15][16]18,19,21,22,26,27,30,32,34,37) Stereotactic radiosurgery provides excellent outcomes with local tumor control rates of 85-100%, but these rates tend to fall with longer follow-up periods.…”