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Petroclival Meningioma

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https://www.readbyqxmd.com/read/28967316/combined-petrosal-approach-for-petroclival-meningioma
#1
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
#2
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
#3
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
#4
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/28862550/voxel-based-lesion-mapping-of-meningioma-a-comprehensive-lesion-location-mapping-of-260-lesions
#5
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
#6
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/28683438/gamma-knife-radiosurgery-for-petroclival-meningioma-long-term-outcome-and-failure-pattern
#7
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
#8
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)...
May 24, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28338439/stereotactic-radiosurgery-in-the-treatment-of-parasellar-meningiomas-long-term-volumetric-evaluation
#9
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...
March 24, 2017: 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
#10
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
https://www.readbyqxmd.com/read/28203025/-trigemino-cardiac-reflex-in-skull-base-surgery
#11
H Z Duan, Y Zhang, L Li, J Y Zhang, Z Q Yi, S D Bao
OBJECTIVE: To explore the mechanism, clinical features, and prognosis of Trigemino-cardiac reflex (TCR) during skull base operations. METHODS: A retrospective analysis was performed on 291 patients with skull base disease from Jan. 2009 to Oct. 2015 in Peking University First Hospital. By reviewing the patients' operative data and anaesthetic electrical record, and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures, clinical features, influence factors, and prognosis...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28124175/preoperative-simulation-of-the-running-course-of-the-abducens-nerve-in-a-large-petroclival-meningioma-a-case-report-and-literature-review
#12
REVIEW
Kaichuang Yang, Fusao Ikawa, Shumpei Onishi, Manish Kolakshyapati, Masaaki Takeda, Satoshi Yamaguchi, Minoru Ishifuro, Yuji Akiyama, Mizuki Morishige, Kaoru Kurisu
One of the most important and useful pieces of information in the preoperative evaluation of a large petroclival meningioma is the running course of the abducens nerve. The abducens nerve is small and has a long intracranial course, making it prone to compression by the tumor at various anatomical points. In relatively large tumors, it is difficult to confirm the entire course of the abducens nerve, even by heavy T2-thin slice imaging. We report a case of successful preoperative estimation of the course of the abducens nerve that aided in its complete preservation during the resection of a large petroclival tumor...
April 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28109858/radiologic-dilemma-in-an-extra-axial-petroclival-lesion-low-grade-versus-high-grade
#13
Madhivanan Karthigeyan, Chirag Kamal Ahuja, Debjyoti Chatterjee, Pravin Salunke
BACKGROUND: Radiologic differentiation between a low-grade and high-grade lesion is crucial when deciding extent of resection and prognostication. Occasionally, imaging features can be confusing between the 2 lesions. We report a case that presented such a radiologic dilemma. The lesion appeared benign and extra-axial on routine magnetic resonance imaging sequences. However, subtle clinical and imaging clues pointed to a high-grade lesion. CASE DESCRIPTION: A 27-year-old woman presented with multiple cranial nerve palsies, gait ataxia, and features of increased intracranial pressure...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28035290/pathological-location-of-cranial-nerves-in-petroclival-lesions-how-to-avoid-their-injury-during-anterior-petrosal-approach
#14
Hamid Borghei-Razavi, Ryosuke Tomio, Seyed-Mohammad Fereshtehnejad, Shunsuke Shibao, Uta Schick, Masahiro Toda, Kazunari Yoshida, Takeshi Kawase
Objectives Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used...
February 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27965073/outcomes-of-endonasal-and-lateral-approaches-to-petroclival-meningiomas
#15
Maria Koutourousiou, Juan C Fernandez-Miranda, Francisco Vaz-Guimaraes Filho, John R de Almeida, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE: Transpetrosal approaches for the treatment of petroclival meningiomas are often associated with substantial morbidity and long recovery. With the goal of early clinical improvement, we have used less invasive surgical approaches for petroclival meningiomas. METHODS: We retrospectively reviewed 32 patients with petroclival meningiomas. Eleven patients (34.4%) were managed with lateral approaches (retrosigmoid or far lateral approach), 17 (53.1%) with anterior midline approaches (endoscopic endonasal approach [EEA]), and 4 (12...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27941420/the-natural-history-of-petroclival-meningiomas-a-volumetric-study
#16
Jacob B Hunter, Robert J Yawn, Ray Wang, Brendan P O'Connell, Matthew L Carlson, Akshitkumar Mistry, David S Haynes, Reid C Thompson, Kyle D Weaver, George B Wanna
OBJECTIVES: This study characterizes primary petroclival meningioma growth rates, before intervention, using volumetric analysis. In addition, predictors of growth are analyzed. METHODS: Patients with previously untreated petroclival meningiomas were retrospectively reviewed (1999-2015). Image analysis software was used to perform volumetric analyses of tumor size and growth. Three-dimensional segmentation volumetric analyses were compared with volumes estimated utilizing three orthogonal dimensions...
January 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/27935362/dramatic-radiographic-response-resulting-in-cerebrospinal-fluid-rhinorrhea-associated-with-sunitinib-therapy-in-recurrent-atypical-meningioma-case-report
#17
Amol Raheja, Howard Colman, Cheryl A Palmer, William T Couldwell
Sunitinib is a multiple tyrosine kinase inhibitor with antiangiogenic, cytostatic, and antimigratory activity for meningiomas. A recent clinical trial of sunitinib for treatment of recurrent Grade II and III meningiomas suggested potential efficacy in this population, but only 2 patients exhibited significant radiographic response with tumor volume reduction. The authors illustrate another such case and discuss a complication related to this dramatic tumor volume reduction in aggressive skull base meningiomas...
November 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27915104/petroclival-meningiomas-remaining-controversies-in-light-of-minimally-invasive-approaches
#18
REVIEW
Sâmia Yasin Wayhs, Guilherme Alves Lepski, Leonardo Frighetto, Gustavo Rassier Isolan
Surgical resection of petroclival meningiomas remains challenging due to their deep location and relationship to vital neurovascular structures. Although the natural history of these tumors involves a slow course, the incidence of cranial nerve deficits and the extent of tumor resection vary widely in the literature. Some reviews on this topic have been conducted, but data remain fragmentary and based on retrospective case series, which hinders attempts at meta-analysis. Within this context, research into the use of minimally invasive approaches, including in neuroendoscopy, continues to emerge...
January 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27787647/pediatric-intracranial-clear-cell-meningioma-a-clinicopathological-study-of-seven-cases-and-literature-review
#19
REVIEW
Hao Li, Meng Zhao, Yuming Jiao, Zhicen Li, Ji Ma, Shuo Wang, Yong Cao, Jizong Zhao
BACKGROUND: In this study, we reported seven cases of pediatric intracranial clear cell meningiomas (CCMs) in our institution and reviewed the relevant literature to investigate the clinicopathological characteristics, treatment options, and prognosis of these rare tumors. METHODS: From January 2005 to June 2016, we retrospectively reviewed seven pediatric intracranial CCMs in terms of their clinical data, preoperative MRI features, and prognosis. Moreover, a critical review of the English language literature was also conducted...
February 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27567583/true-petroclival-meningiomas-proposal-of-classification-and-role-of-the-combined-supra-infratentorial-presigmoid-retrolabyrinthine-approach
#20
Tanya E Sassun, Andrea G Ruggeri, Roberto Delfini
BACKGROUND: The evolution of the surgical treatment of petroclival meningiomas (PMs) has led to a tendency to abandon complex petrous approaches and return to "less-aggressive" skull base approaches. OBJECTIVE: To propose a classification of PMs and establish the role of the combined supra-infratentorial presigmoid retrolabyrinthine (CSIPR) approach in the treatment of PMs rigorously matching the anatomical definition. METHODS: A retrospective analysis was conducted of 51 cases of PMs strictly adhering to the anatomical definition who were operated on from January 1990 to December 2011...
December 2016: World Neurosurgery
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