Petroclival meningiomas: Surgical management and common complications

Tahara, Adriana; Santana, Pedro; Maldaun, Marcos Vinícius Calfat; Panagopoulos, Alexandros; Silva, Arnaldo Neves da; Zicarelli, Carlos Alexandre Martins; Aguiar, Paulo Henrique Pires de

doi:10.1016/j.jocn.2008.08.011

Cited by 47 publications

(31 citation statements)

References 24 publications

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“…More recent series have also reported zero mortality (1,19,20,23). The reported rate of total tumor resection has increased from a low 25% up to 86% (1,14,20,22). In our series, of 11 cases of petroclival meningioma, total resection was achieved in 5 patients (45%).…”

Section: Discussionsupporting

confidence: 51%

“…In 1992, Samii and Tatagiba reported successful total removal in 27 (75%) of the 36 patients with petroclival meningiomas on whom they operated between 1978 and 1990; they had no postoperative death, and in 83%, no severe morbidity (16). More recent series have also reported zero mortality (1,19,20,23). The reported rate of total tumor resection has increased from a low 25% up to 86% (1,14,20,22).…”

Section: Discussionmentioning

confidence: 99%

“…Complication related to surgical management of petroclival meningiomas remains as high as 50% and usually are related to cranial nerve deficits that are transient in the majority of cases (1,15,19,20,22). The most serious complications are related to brain stem injury, which is very severe and is usually due to compromise of the blood supply to the brain stem (1,15,22).…”

Section: Discussionmentioning

confidence: 99%

“…The most serious complications are related to brain stem injury, which is very severe and is usually due to compromise of the blood supply to the brain stem (1,15,22). In the most recent series, these complications have decreased due to the use of microsurgical techniques and a better understanding of the anatomic behavior of these tumors (20). Depending on the size of the petroclival meningioma, any of the cranial nerves can be injured during surgery in a retrosigmoid approach (17).…”

Section: Discussionmentioning

confidence: 99%

“…Complete injury to the trigeminal nerve is less frequent due to its large size, but a trigeminal nerve paresis is a frequent occurrence. Because the facial nerve is usually displaced posteriorly by the tumor, it is injured especially in large size petroclival meningioma (17,18,20). Loss of hearing is common with patients with petroclival meningiomas.…”

Section: Discussionmentioning

confidence: 99%

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Surgery of petroclival meningiomas. Recent surgical results and outcomes

Rădoi¹,

Stefanescu²,

Vakilnejad³

et al. 2015

Romanian Neurosurgery

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Petroclival meningiomas represent only 10% of all meningiomas located in the posterior fossa, but are some of the most formidable challenges in skull base surgery. We described our recent experience (2005 regarding the surgery of these tumors. We retrospectively analyzed surgical results and outcome in 11 cases of petroclival meningiomas. Most common symptoms in our series were headache and gait disturbance, while cranial nerves palsies represented the most common presenting signs. There were 8 females and 3 males, and the mean age was 52 years. Surgical approaches chosen for petroclival meningiomas in our series were retrosigmoid (9 patients) and subtemporal transtentorial (2 patients). We achieved total tumor resection in 5 cases (45%) and subtotal resection in 6 cases (55%). Overall outcome (total/subtotal resection) was good in 6 cases, fair in 3 cases and poor in one case. One postoperative death occurred due to hemorrhagic midbrain infarction (9%). Complications were usually related to cranial nerve deficits: loss of hearing (2 patients), paresis of trochlear nerve (1 patient), trigeminal nerve (3 patients) and facial nerve (1 patient). In 4 patients these cranial nerves deficits were transient. In one case, a patient developed postoperative hydrocephalus and needed shunt placement. Despite the fact that complications can be disastrous, we considered that an appropriate approach, combined with microsurgical techniques and a better understanding of the anatomy, greatly decrease the incidence and severity of complications and make feasible a total tumor resection.

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