J Neurol Surg B 2019; 80(04): 380-391
DOI: 10.1055/s-0038-1675589
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Approach Selection and Surgical Planning in Posterior Cranial Fossa Meningiomas: How I Do It

André Beer-Furlan
1  Department of Neurological Surgery, Rush University Medical Center, Chicago, IL, United States
,
Eduardo A. Vellutini
2  DFVneuro - Division of Neurosurgery, São Paulo, São Paulo, Brazil
,
Marcos Q. T. Gomes
2  DFVneuro - Division of Neurosurgery, São Paulo, São Paulo, Brazil
,
Alberto C. Cardoso
2  DFVneuro - Division of Neurosurgery, São Paulo, São Paulo, Brazil
,
Luciano M. Prevedello
3  Department of Radiology, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Alexandre B. Todeschini
4  Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Daniel M. Prevedello
4  Department of Neurological Surgery, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, Ohio, United States
› Author Affiliations Disclosure of Funding None.
Further Information

Publication History

01 June 2018

23 September 2018

Publication Date:
31 October 2018 (eFirst)

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Abstract

Posterior cranial fossa meningiomas represent approximately 9% of all the intracranial meningiomas. Despite the recent reports of radiation therapy in the management of these tumors, surgical resection continues to be the first line of treatment method aiming the permanent meningioma eradication. The evolution of imaging studies improved the preoperative evaluation of meningiomas providing greater anatomical detail of small structures not previously visualized. Nonetheless, the preoperative radiological evaluation should go beyond the differential diagnosis of a posterior fossa tumor. Anatomo-radiological assessment of meningiomas is discussed in detail. Based on our clinical experience, literature review, and case illustration, we highlight important preoperative anatomo-radiological aspects of posterior fossa meningiomas and their implications in the surgical management of these tumors.

Keywords

meningioma - posterior fossa - clival meningioma - petroclival meningioma - foramen magnum meningioma - jugular foramen meningioma - cerebellopontine angle meningioma - surgical approaches