Anterior Clinoidal Meningiomas

Lee, Joung H.; Sade, Burak

doi:10.1007/978-1-84628-784-8_36

Cited by 5 publications

(25 citation statements)

References 22 publications

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“…ACMs were classified by Al-Mefty into three groups based on their anatomical relation to the ICA. [ 2 18 ] Tumors that originate proximal to the end of the carotid cistern and encase the ICA with direct attachment to its adventitia, and are not separated by an arachnoid plane, constitute group I. This subtype usually extends laterally and inferior to the ACP, which makes the endoscopic resection unfeasible and risky.…”

Section: Discussionmentioning

confidence: 99%

“…Anterior Clinoidal Meningiomas (ACMs) represent special entity of meningiomas that have been referred to as, or grouped with, suprasellar, parasellar, sphenoid wing, or frontal skull base meningiomas. [ 18 ] They often are mentioned in the same context as meningiomas originating from tuberculum sellae, diaphragma sellae, planum sphenoidale, or optic canal meningiomas. ACMs, originating from the arachnoid layer covering the anterior clinoid process (ACP),[ 18 ] has an incidence of 34% to 43.9% of all sphenoidal meningiomas.…”

Section: Introductionmentioning

confidence: 99%

“…[ 18 ] They often are mentioned in the same context as meningiomas originating from tuberculum sellae, diaphragma sellae, planum sphenoidale, or optic canal meningiomas. ACMs, originating from the arachnoid layer covering the anterior clinoid process (ACP),[ 18 ] has an incidence of 34% to 43.9% of all sphenoidal meningiomas. [ 2 ] With its tendency to extend laterally, and its proximity to the optic nerve (ON), the internal carotid artery (ICA) and its branches, it constitutes a surgical challenge to neurosurgeons, in terms of subsequent morbidity and achievement of gross total resection.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 ] With its tendency to extend laterally, and its proximity to the optic nerve (ON), the internal carotid artery (ICA) and its branches, it constitutes a surgical challenge to neurosurgeons, in terms of subsequent morbidity and achievement of gross total resection. [ 18 ] Another challenge is the choice of surgical approach to these types of tumors. Whereas different transcranial approaches have been proposed in the literature, there is paucity of studies reporting the implementation and description of a purely endoscopic approach to resect ACMs.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic transnasal suprasellar approach for anterior clinoidal meningioma: A case report and review of the literature

Bardeesi¹,

Alsaleh

Ajlan

2017

Surg Neurol Int

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Background:Anterior clinoidal meningiomas (ACM) are traditionally approached through transcranial routes. Due to their tendency to extend laterally and their proximity to vital neurovascular structures, the endoscopic transnasal suprasellar approach is still questionable. We present and describe an ACM case that underwent an endoscopic transnasal suprasellar approach, and provide a review of the literature and operative technique.Case Description:A 56 year-old lady who presented with chronic left-sided decreased vision. Brain imaging revealed a lesion measuring 9 × 10 × 11 mm attached to the left anterior clinoid process (ACP) and extending to the left optic canal. Lesion was compressing the left optic nerve (ON) and abutting the supraclinoid part of the left internal carotid artery (ICA). Utilizing the endoscopic transnasal suprasellar approach, the meningioma was resected and the optic canal was decompressed. Reconstruction was achieved using fascia lata, vomer bone, and nasoseptal flap. A lumbar drain was inserted perioperatively. Patient had no perioperative morbidity and retained vision in the affected eye.Conclusions:Resection of selected ACMs can be safely achieved utilizing the endoscopic transnasal suprasellar approach. Although the literature lacks long-term outcome comparison between the transnasal and the traditional transcranial approaches, specifically addressing ACMs, this technique is becoming more popular over the last decade. More efforts should be directed towards implementing and reporting the endoscopic transnasal suprasellar approach for meningiomas of the anterior clinoid process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic transnasal suprasellar approach for anterior clinoidal meningioma: A case report and review of the literature

Bardeesi¹,

Alsaleh

Ajlan

2017

Surg Neurol Int

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“…The point is made that with larger tumours near the cavernous sinus precise definition of the site of origin may not be possible. 42 In the chapter on medial sphenoidal ridge meningiomas a special classification system was used with sphenoidal ridge meningiomas which were divided into 5 categories. 43 In the chapter on cavernous sinus meningiomas, the precise definition of the term is not outlined.…”

Section: Clinical Materialsmentioning

confidence: 99%

Protection of the anterior visual pathways during gamma knife treatment of meningiomas

Ganz¹,

El-Shehaby

Reda

et al. 2010

British Journal of Neurosurgery

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The anterior visual pathway (AVP) can be at risk during gamma knife surgery (GKS). There is no standardised published methodology for protecting the AVP. This paper suggests such an approach in relation to the treatment of meningiomas. There were 67 patients with a mean age of 48.8 years and a minimum follow-up of 25 months. A recent perimetry was available on the day of treatment. The visual pathway was outlined and the maximum radiation dose was recorded. In some cases a dose volume histogram (DVH) of the AVP was constructed to assess the volume receiving more than the desired maximum dose. The aim was a maximum dose between 8 and 10 Gy. A principle of sub-optimal dose planning was used to protect vision. Follow-up included new visual field examinations. Various anatomical locations place different parts of the AVP at risk. No patient suffered a deterioration of vision. In 21 (38.7%) patients there was an improvement in the visual field and in 7 (44%) associated diplopia improved. Vision could improve without corresponding tumour shrinkage. A standard measure of radiation toleration of the AVP could be the maximum dose within its volume, probably at least 10 Gy. Computerised perimetry should be available on the day of treatment and at follow-up. There is no need to have a distance between the tumour margin and the visual pathway. Sub-optimal dose-planning has been advantageous. Improvement in vision is not necessarily a consequence of tumour shrinkage.

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