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petroclival tumors

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https://www.readbyqxmd.com/read/29777891/surgical-strategy-for-and-anatomical-locations-of-petroapex-and-petroclival-meningiomas-based-on-evaluation-of-the-feeding-artery
#1
Kazuhide Adachi, Mituhiro Hasegawa, Shinichiro Tateyama, Yushi Kawazoe, Yuichi Hirose
OBJECTIVE: The anterior transpetrosal (ATP) approach is the most appropriate approach for petroclival meningiomas, which are typically located from the dorsum sellae to the upper border of the internal acoustic meatus (IAM). Although neurosurgeons can resect over this area if the tumor is detached from the dura, tumors within the indication area for petroclival meningiomas is insufficient for the selection of the ATP approach because it can be difficult to evaluate whether the tumor is attached or only touching the dura...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29691775/cranial-nerve-outcomes-after-primary-stereotactic-radiosurgery-for-symptomatic-skull-base-meningiomas
#2
Andrew Faramand, Hideyuki Kano, Ajay Niranjan, Stephen A Johnson, Mohab Hassib, Kyung-Jae Park, Yoshio Arai, John C Flickinger, L Dade Lunsford
OBJECTIVE: To evaluate cranial nerve (CN) outcomes after primary stereotactic radiosurgery (SRS) for petroclival, cavernous sinus, and cerebellopontine angle meningiomas. METHODS: From our prospectively maintained database of 2022 meningioma patients who underwent Leksell stereotactic radiosurgery (SRS) during a 30-year interval, we found 98 patients with petroclival, 242 with cavernous sinus, and 55 patients with cerebellopontine angle meningiomas. Primary radiosurgery was performed in 245 patients...
April 24, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29607683/petroclival-tension-pneumocephalus-an-unrivalled-life-threatening-complication-linked-to-molecular-targeted-therapy
#3
Alhusain Nagm, Toshihiro Ogiwara, Akihiro Nishikawa, Shunsuke Ichinose, Kazuhiro Hongo
A 73-year-old man with a petroclival tumor (metastatic renal cell carcinoma) presented with a progressive consciousness disturbance attributed to tension pneumocephalus during molecular-targeted therapy following low-dose fractionated radiotherapy for a petroclival tumor. The skull base defect was successfully reconstructed vi an endoscopic endonasal approach.
April 2, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29587795/clinical-outcome-after-particle-therapy-for-meningiomas-of-the-skull-base-toxicity-and-local-control-in-patients-treated-with-active-rasterscanning
#4
Rami A El Shafie, Maja Czech, Kerstin A Kessel, Daniel Habermehl, Dorothea Weber, Stefan Rieken, Nina Bougatf, Oliver Jäkel, Jürgen Debus, Stephanie E Combs
BACKGROUND: Meningiomas of the skull base account for 25-30% of all meningiomas. Due to the complex structure of the cranial base and its close proximity to critical structures, surgery is often associated with substantial morbidity. Treatment options include observation, aggressive surgical intervention, stereotactic or conventional radiotherapy. In this analysis we evaluate the outcome of 110 patients with meningiomas of the skull base treated with particle therapy. It was performed within the framework of the "clinical research group heavy ion therapy" and supported by the German Research Council (DFG, KFO 214)...
March 27, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29547085/analysis-of-various-tracts-of-mastoid-air-cells-related-to-csf-leak-after-the-anterior-transpetrosal-approach
#5
Ryota Tamura, Ryosuke Tomio, Farrag Mohammad, Masahiro Toda, Kazunari Yoshida
OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed...
March 16, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29492152/combined-retrosigmoid-paramedian-supracerebellar-transtentorial-approach-as-an-alternative-to-classical-transtemporal-approaches-a-technical-note
#6
Tamer Altay, Cem Akkurt
Epidermoid tumors are rare benign neoplasms. They commonly occur in the parasellar region and the cerebellopontine angle but may sometimes present in the so-called petroclival region, or beyond the boundaries of this location. For those that are localized in multiple compartments, staged surgeries, extensive transtemporal approaches, or somewhat limited extended middle fossa approach are generally performed. Although a good resection can be achieved by these approaches, they carry relatively high morbidity and mortality...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29408770/factors-of-influence-upon-the-sf-36-based-health-related-quality-of-life-of-patients-following-surgery-for-petroclival-and-lateral-posterior-surface-of-pyramid-meningiomas
#7
B Pintea, J A Kandenwein, H Lorenzen, J P Boström, F Daher, V Velazquez, R A Kristof
OBJECTIVE: To describe the patient's self assessed health related quality of life (saHRQoL) based upon the medical outcome study 36-item short form health survey (SF-36) as well as the factors of influence upon the saHRQoL following surgery for petroclival (PCM) and lateral posterior surface of the pyramid (LPPM) meningiomas. PATIENTS AND METHODS: In a series of 78 patients operated consecutively for PCM (n = 46) or LPPM (n = 32) the preoperative, intraoperative and postoperative data were collected retrospectively...
March 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29372884/volumetric-changes-and-clinical-outcome-for-petroclival-meningiomas-after-primary-treatment-with-gamma-knife-radiosurgery
#8
Zjiwar H A Sadik, Suan Te Lie, Sieger Leenstra, Patrick E J Hanssens
OBJECTIVE Petroclival meningiomas (PCMs) can cause devastating clinical symptoms due to mass effect on cranial nerves (CNs); thus, patients harboring these tumors need treatment. Many neurosurgeons advocate for microsurgery because removal of the tumor can provide relief or result in symptom disappearance. Gamma Knife radiosurgery (GKRS) is often an alternative for surgery because it can cause tumor shrinkage with improvement of symptoms. This study evaluates qualitative volumetric changes of PCM after primary GKRS and its impact on clinical symptoms...
January 26, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28967316/combined-petrosal-approach-for-petroclival-meningioma
#9
Omar Arnaout, Ossama Al-Mefty
The authors present the case of a 56-year-old patient who presented with a large petroclival meningioma and clinical symptoms of brainstem compression and hydrocephalus. The authors describe a two-stage combined petrosal approach for complete resection of the tumor. The nuances of the approach and microsurgical technique are discussed, as well as the radiographic and clinical outcomes. The video can be found here: https://youtu.be/JxoTXS-uiHM .
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967313/extended-middle-fossa-approach-with-anterior-petrosectomy-for-resection-of-upper-petroclival-meningioma-involving-meckel-s-cave-operative-video-and-technical-nuances
#10
James K Liu
The surgical management of petroclival meningiomas remains a formidable challenge. These tumors are deep in the base of the skull and arise medial to the fifth cranial nerve. In this operative video, the author demonstrates the extended middle fossa approach with anterior petrosectomy to resect an upper petroclival meningioma extending into Meckel's cave with brainstem compression. This approach is very useful for accessing deep tumors located above and below the tentorium, and between the fifth and seventh cranial nerves...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967312/resection-of-middle-petroclival-meningioma-via-combined-anterior-transpetrosal-and-retrosigmoid-approaches-at-two-separate-stages-3d-operative-video
#11
Ihsan Dogan, Pinar Eser Ocak, G Mark Pyle, Mustafa K Başkaya
Surgical access to the petroclival region poses a challenge to neurosurgeons. A wide range of approaches has been demonstrated in the past. In this video, the authors present a 69-year-old male patient who presented with 3-month history of worsening left-sided numbness. The tumor was totally removed in 2 sessions via anterior transpetrosal and retrosigmoid approaches, respectively. The authors demonstrate 2 separate skull base approaches to resect a petroclival meningioma and discuss pitfalls and problems of management for challenging meningiomas...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28967307/introduction-surgical-management-of-skull-base-meningiomas
#12
Gabriel Zada, Mustafa K Başkaya, Mitesh V Shah
Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962038/site-specific-considerations-in-the-surgical-management-of-skull-base-chondrosarcomas
#13
Shaan M Raza, Paul W Gidley, Michael E Kupferman, Ehab Y Hanna, Shirley Y Su, Franco DeMonte
BACKGROUND: Numerous approaches have been reported in the management of skull base chondrosarcomas. Data are lacking for surgical outcomes by the tumor site of origin. OBJECTIVE: To provide insight into outcomes by site of origin and factors affecting resection in order to aid in surgical approach selection. METHODS: A retrospective review was conducted of 49 patients with chondrosarcoma treated at our institution. Charts were reviewed for tumor- and treatment-related factors...
June 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28862550/voxel-based-lesion-mapping-of-meningioma-a-comprehensive-lesion-location-mapping-of-260-lesions
#14
Ryuichi Hirayama, Manabu Kinoshita, Hideyuki Arita, Naoki Kagawa, Haruhiko Kishima, Naoya Hashimoto, Yasunori Fujimoto, Toshiki Yoshimine
OBJECTIVE In the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques. METHODS Magnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28725517/preoperative-embolization-for-skull-base-meningiomas
#15
Kensuke Suzuki, Masaya Nagaishi, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Ryotaro Suzuki, Yosuke Kawamura, Ryuta Nakae, Yoshihiro Tanaka, Akio Hyodo
The results of preoperative embolization for skull base meningiomas were retrospectively evaluated to confirm the efficacy of this procedure. Skull base meningiomas that were treated with preoperative embolization were evaluated in 20 patients. The occluded arteries, embolic materials, treatment time, excision rate, neurologic manifestations, and complications were analyzed. The embolic material was 80% liquid, 30% coils, and 15% particles. The surgery was normally completed within 3 to 5 hours. Blood loss was normally approximately 250 mL, excluding four patients having the following conditions: malignant meningioma, a large tumor located on the medial side of the sphenoidal ridge, the petroclival tumor, and infiltrated tumor into the sigmoid sinus...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28713632/radiographic-assessment-of-the-presigmoid-retrolabyrinthine-approach
#16
Andrew K Wong, Melissa M Stamates, Anita P Bhansali, Michael Shinners, Ricky H Wong
BACKGROUND: Lesions of the petroclival fissure are difficult to access surgically. Both retrosigmoid and presigmoid retrolabyrinthine approaches have been described to successfully treat these complex tumors. The retrosigmoid approach offers quick and familiar access, whereas the presigmoid retrolabyrinthine approach reduces the operative distance and the need for cerebellar retraction. The presigmoid retrolabyrinthine approach, however, is constrained by anatomical limits that can be subject to patient variation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28683438/gamma-knife-radiosurgery-for-petroclival-meningioma-long-term-outcome-and-failure-pattern
#17
Jin Wook Kim, Dong Gyu Kim, Young-Bem Se, Sung Kwon Kim, Hyun-Tai Chung, Sun Ha Paek, Hee-Won Jung
Total removal of petroclival meningioma is difficult, and aggressive extirpation is often associated with significant surgical morbidity and mortality. The aim of this study was to evaluate the long-term outcome and failure pattern of treatment with Gamma Knife radiosurgery (GKRS) in patients with petroclival meningiomas. Eighty-nine consecutive patients with petroclival meningiomas underwent GKRS between 1998 and 2013. Fifty-eight patients received GKRS as a primary treatment and 31 patients underwent GKRS as a secondary treatment after microsurgery...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28541487/tumor-progression-following-petroclival-meningioma-subtotal-resection-a-volumetric-study
#18
Jacob B Hunter, Brendan P O'Connell, Matthew L Carlson, Lola C Chambless, Robert J Yawn, Ray Wang, Akshitkumar Mistry, Reid C Thompson, Kyle D Weaver, George B Wanna
BACKGROUND: One study has investigated postoperative growth rates following subtotal resection of petroclival meningiomas utilizing linear measurements, which are insensitive to the multidimensional complex growth of meningiomas, to estimate tumor volume. OBJECTIVE: To describe petroclival meningioma growth patterns following less-than-complete resection utilizing volumetric analysis and to identify variables associated with tumor progression. METHODS: Patients with surgically resected WHO grade I petroclival meningiomas were retrospectively reviewed (1999-2015)...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28338439/stereotactic-radiosurgery-in-the-treatment-of-parasellar-meningiomas-long-term-volumetric-evaluation
#19
Or Cohen-Inbar, Athreya Tata, Shayan Moosa, Cheng-Chia Lee, Jason P Sheehan
OBJECTIVE Parasellar meningiomas tend to invade the suprasellar, cavernous sinus, and petroclival regions, encroaching on adjacent neurovascular structures. As such, they prove difficult to safely and completely resect. Stereotactic radiosurgery (SRS) has played a central role in the treatment of parasellar meningiomas. Evaluation of tumor control rates at this location using simplified single-dimension measurements may prove misleading. The authors report the influence of SRS treatment parameters and the timing and volumetric changes of benign WHO Grade I parasellar meningiomas after SRS on long-term outcome...
February 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28330424/tentorial-meningioma-supplied-by-a-marginal-tentorial-artery-arising-from-the-superior-cerebellar-artery-anatomic-and-technical-considerations
#20
Stéphanie Lenck, Kentaro Watanabe, Jean-Pierre Saint-Maurice, Moujahed Labidi, Marc-Antoine Labeyrie, Sébastien Froelich, Emmanuel Houdart
Background and importance The marginal tentorial artery runs over the free edge of the tentorium. Different origins have been described, always involving branches of the carotid artery. We report the superior cerebellar artery as an unknown origin of this artery. We developed our strategy in a case of a tentorial meningioma mainly supplied by this artery. Clinical presentation A 53-year-old man was admitted in our institution for the surgical treatment of a large tentorial and petroclival meningioma. A 2D conventional angiogram was insufficient to detect the tumoral blush...
August 2017: Interventional Neuroradiology
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