[Tentorial meningiomas. A study of 14 surgically verified cases]

Complete surgical resection is considered to be the elective treatment for tentorial meningiomas. The objective of this work is to describe the clinical and radiological characteristics of these tumours, the best surgical approach, complications related to surgery and long term outcome of patients harbouring a meningioma at this location.

A series of 14 patients with tentorial meningiomas consecutively operated at our department between 1977 and 1999 is analyzed. Twelve patients were studied with CT and the last 8 with MR. Arteriography or angio-MR were performed in some patients when dural sinuses involvement was suspected. Tumoral resection was evaluated by means of Simpson Scale and final outcome according to the Glasgow Outcome Scale (GOS).

Nine patients were female and 5 male. Mean age was 64 years (41-82). The average duration of presenting symptoms was 17 months. Headache was the most frequent presenting symptom. The tumour was implanted at the tentorial free edge in 4 cases, at the lateral region in 9 and at the falcotentorial region in 1 case. Complete surgical resection (Simpson I-II) was achieved in 10 cases. Final outcome was good recovery in 9 cases, moderate disability in 1, severe disability in 2 and two patients died.

Surgery is the elective treatment for tentorial meningiomas. In most cases, complete surgical resection should be the objective. Subtotal resection may be considered when the tumour invades a patent dural sinus or the cavernous sinus or when the tumour is closely adherent to the brain stem. In these cases a close follow up is needed and reoperation or radiosurgical treatment may be contemplated if residual tumour growth occurs.