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Clinoidal meningiomas.

O Al-Mefty1

  • 1Department of Neurosurgery, University of Mississippi Medical Center, Jackson.

Journal of Neurosurgery
|December 1, 1990
PubMed
Summary
This summary is machine-generated.

Anterior clinoidal meningiomas pose high risks. Radical total removal is achievable through advanced techniques, with outcomes varying based on tumor-vessel relationships and surgical grouping.

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Area of Science:

  • Neurosurgery
  • Neuro-oncology
  • Skull Base Surgery

Background:

  • Anterior clinoidal meningiomas are often misclassified, obscuring their significant association with high mortality, morbidity, and recurrence rates.
  • Subtotal removal is common due to concerns about injuring encased cerebral vessels, but this leads to expected tumor recurrence.

Purpose of the Study:

  • To report outcomes of 24 cases of anterior clinoidal meningiomas treated with radical total removal.
  • To identify patient subgroups influencing surgical difficulty, extent of resection, and patient outcomes.

Main Methods:

  • Surgical treatment of 24 patients with anterior clinoidal meningiomas, emphasizing radical total removal of tumor, dura, and bone.
  • Classification of patients into three groups (I, II, III) based on the presence of arachnoid membranes between the tumor and cerebral vessels, and the tumor's relationship to the carotid artery.

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Main Results:

  • Total removal was not possible in Group I (3 patients), resulting in one death and one case of hemiplegia.
  • Total removal was achieved in 18 of 19 patients in Group II, with one death from pulmonary embolism.
  • Total removal was easily achieved without complications in both patients in Group III.

Conclusions:

  • The presence or absence of arachnoid membranes, dependent on tumor origin and relation to the carotid artery, dictates surgical feasibility and outcomes.
  • Advanced cranial-base exposure and cavernous sinus surgery techniques enable successful radical total removal of anterior clinoidal meningiomas.
  • A clear classification system is crucial for predicting surgical challenges and patient prognosis in anterior clinoidal meningioma treatment.