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Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type

Abstract Background We retrospectively analyzed a series of patients harboring a FT meningioma with regard to clinical presentation, surgical technique, and follow-up results. Methods Clinical data in a consecutive series of 13 patients treated for a meningioma of the FT junction were retrospectivel...

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Published in:Surgical neurology 2008-04, Vol.69 (4), p.339-349
Main Authors: Bassiouni, Hischam, MD, Asgari, Siamak, MD, König, Hermann-Josef, MD, Stolke, Dietmar, MD
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description Abstract Background We retrospectively analyzed a series of patients harboring a FT meningioma with regard to clinical presentation, surgical technique, and follow-up results. Methods Clinical data in a consecutive series of 13 patients treated for a meningioma of the FT junction were retrospectively reviewed. Tumors were classified into 4 types according to their dural origin and tumor extent as depicted from preoperative MRI. Results Main presenting symptom in 9 women and 4 men (mean age, 56 years) was headache (69%) and gait disturbance (54%). Clinical examination revealed gait ataxia in 62% of the patients. The tumor displaced the vein of Galen inferiorly in 6 patients, superiorly in 2, and medially in 5 cases. The main surgical approach to the meningioma was via an occipital interhemispheric route (10 patients). Additional resection of the falx and/or incision of the tentorium was performed in 6 cases each. A complete resection (Simpson grade 1 and 2) was achieved in 85% of patients. Permanent surgical morbidity was 23%. One tumor recurrence in an atypical meningioma was observed after the mean follow-up period of 6.2 years (range, 1-14 years) with clinical and MRI examination and had to be reoperated. Eighty-five percent of the patients regained full daily activity on follow-up. Conclusions The surgical approach should be tailored to the dural origin and extent of the tumor as depicted from preoperative MRI. Preservation of the straight sinus and Galenic venous system is recommended.
doi_str_mv 10.1016/j.surneu.2007.02.029
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Methods Clinical data in a consecutive series of 13 patients treated for a meningioma of the FT junction were retrospectively reviewed. Tumors were classified into 4 types according to their dural origin and tumor extent as depicted from preoperative MRI. Results Main presenting symptom in 9 women and 4 men (mean age, 56 years) was headache (69%) and gait disturbance (54%). Clinical examination revealed gait ataxia in 62% of the patients. The tumor displaced the vein of Galen inferiorly in 6 patients, superiorly in 2, and medially in 5 cases. The main surgical approach to the meningioma was via an occipital interhemispheric route (10 patients). Additional resection of the falx and/or incision of the tentorium was performed in 6 cases each. A complete resection (Simpson grade 1 and 2) was achieved in 85% of patients. Permanent surgical morbidity was 23%. One tumor recurrence in an atypical meningioma was observed after the mean follow-up period of 6.2 years (range, 1-14 years) with clinical and MRI examination and had to be reoperated. Eighty-five percent of the patients regained full daily activity on follow-up. Conclusions The surgical approach should be tailored to the dural origin and extent of the tumor as depicted from preoperative MRI. Preservation of the straight sinus and Galenic venous system is recommended.</description><identifier>ISSN: 0090-3019</identifier><identifier>EISSN: 1879-3339</identifier><identifier>DOI: 10.1016/j.surneu.2007.02.029</identifier><identifier>PMID: 17707469</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Cohort Studies ; Craniotomy ; Falcotentorial junction ; Female ; Humans ; Male ; Meningeal Neoplasms - diagnostic imaging ; Meningeal Neoplasms - pathology ; Meningeal Neoplasms - surgery ; Meningioma ; Meningioma - diagnostic imaging ; Meningioma - pathology ; Meningioma - surgery ; Microsurgery ; Middle Aged ; Neurology ; Occipital Bone ; Pineal region ; Radiography ; Retrospective Studies ; Surgery ; Surgical approach ; Treatment Outcome ; Vein of Galen</subject><ispartof>Surgical neurology, 2008-04, Vol.69 (4), p.339-349</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-fd091622a690604f3bd5a077eddbaa176bcebfe00bc5def5c45406a1fb5d59c53</citedby><cites>FETCH-LOGICAL-c415t-fd091622a690604f3bd5a077eddbaa176bcebfe00bc5def5c45406a1fb5d59c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17707469$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bassiouni, Hischam, MD</creatorcontrib><creatorcontrib>Asgari, Siamak, MD</creatorcontrib><creatorcontrib>König, Hermann-Josef, MD</creatorcontrib><creatorcontrib>Stolke, Dietmar, MD</creatorcontrib><title>Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type</title><title>Surgical neurology</title><addtitle>Surg Neurol</addtitle><description>Abstract Background We retrospectively analyzed a series of patients harboring a FT meningioma with regard to clinical presentation, surgical technique, and follow-up results. Methods Clinical data in a consecutive series of 13 patients treated for a meningioma of the FT junction were retrospectively reviewed. Tumors were classified into 4 types according to their dural origin and tumor extent as depicted from preoperative MRI. Results Main presenting symptom in 9 women and 4 men (mean age, 56 years) was headache (69%) and gait disturbance (54%). Clinical examination revealed gait ataxia in 62% of the patients. The tumor displaced the vein of Galen inferiorly in 6 patients, superiorly in 2, and medially in 5 cases. The main surgical approach to the meningioma was via an occipital interhemispheric route (10 patients). Additional resection of the falx and/or incision of the tentorium was performed in 6 cases each. A complete resection (Simpson grade 1 and 2) was achieved in 85% of patients. Permanent surgical morbidity was 23%. One tumor recurrence in an atypical meningioma was observed after the mean follow-up period of 6.2 years (range, 1-14 years) with clinical and MRI examination and had to be reoperated. Eighty-five percent of the patients regained full daily activity on follow-up. Conclusions The surgical approach should be tailored to the dural origin and extent of the tumor as depicted from preoperative MRI. 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subjects Adult
Aged
Cohort Studies
Craniotomy
Falcotentorial junction
Female
Humans
Male
Meningeal Neoplasms - diagnostic imaging
Meningeal Neoplasms - pathology
Meningeal Neoplasms - surgery
Meningioma
Meningioma - diagnostic imaging
Meningioma - pathology
Meningioma - surgery
Microsurgery
Middle Aged
Neurology
Occipital Bone
Pineal region
Radiography
Retrospective Studies
Surgery
Surgical approach
Treatment Outcome
Vein of Galen
title Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type
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