Microsurgical management of tuberculum sellae meningiomas. Results in 28 consecutive cases

A series of 28 cases of meningioma of the tuberculum sellae is reviewed. This tumor was most frequent in the fifth decade, with a clear predominance in women. Neurological and endocrine deficits were minimal, whereas ophthalmologic signs were always present. Visual deficits were bilateral in cases with more than a 1-year history. Osteoma of the tuberculum sellae was rare and had no correlation with tumor size. Angiography of the internal carotid artery was found useful in demonstrating vascular displacements and tumor blush. Computed tomography was the most reliable diagnostic tool. All patients underwent a unilateral pterional craniotomy using the operating Outside of patients with total blindness, improvement of visual acuity was the rule, even in cases of long-term duration. Best results were obtained in patients operated upon within 1 year of the onset of visual symptoms.