Petroclival Meningiomas

  • Madjid Samii
  • Mario Ammirati

Abstract

The present system of classification of petroclival meningiomas and of posterior fossa meningiomas in general is largely inadequate. The amount of in formation that it conveys is at times confused, misleading, and insufficient to allow for meaningful comparisons of different series. This problem is discussed in Chap. 12, and it is of even more relevance in the context of petroclival meningiomas. If a petroclival meningioma is one involving the apical petrous bone and the clivus without further qualification, many of our meningiomas of the anterior group of the posterior pyramid should be labeled as petroclival meningiomas, but this is inappropriate because the main direction of growth and the main bulk of these tumors are more posterior, and their surgical problems are different from those of petroclival meningiomas. On the other hand, if the dural attachment, sometimes diffuse and not always precisely identifiable [12], is the determining criterion, small meningiomas of the clivus, apical petrous bone, or petroclival synchondrosis should be considered petroclival meningiomas, although their surgical problems, outcome, etc. are different from those of larger tumors -while meningiomas arising from the tentorial notch but whose direction of growth leads them to extend well below the incisura to involve the petrous bone and clivus should not be considered petroclival meningiomas.

Keywords

Carbide Drilling Neurol Pyramid Meningioma 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Al Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22:510–517CrossRefGoogle Scholar
  2. 2.
    Castellano F, Ruggiero G (1953) Meningiomas of the posterior fossa. Acta Radiol [Suppl] (Stockh) 104: 1–157Google Scholar
  3. 3.
    Decker RE, Malis LI (1970) Surgical approaches to mid line lesions at the base of the skull: a review. Mt Sinai J Med (NY) 37:84–102Google Scholar
  4. 4.
    Hakuba A, Nishimura S (1981) Total removal of clivus meningiomas and the operative results. Neurol Med Chir 21:59–73CrossRefGoogle Scholar
  5. 5.
    Hakuba A, Nishimura S, Jo Jang B (1988) A combined retroauricular and preauricular transpetrosal-transtentorial approach to clivus meningiomas. Surg Neurol 30:108–116PubMedCrossRefGoogle Scholar
  6. 6.
    Kempe LG (1970) Operative neurosurgery, vol 2. Sprin ger, Berlin Heidelberg New York, pp 45–53Google Scholar
  7. 7.
    Malis LI (1985) Surgical resection of tumours of the skull base. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, vol 1. McGraw-Hill, pp 1011–1021Google Scholar
  8. 8.
    Mayberg MR, Symon LD (1986) Meningiomas of the clivus and apical petrous bone. Report of 35 cases. J Neurosurg 65:160–167PubMedCrossRefGoogle Scholar
  9. 9.
    Samii M, Ammirati M (1988) The combined supra-in-fratentorial presigmoid sinus avenue to the petroclival region. Surgical technique and clinical applications. Acta Neurochir (Wien) 95:6–12CrossRefGoogle Scholar
  10. 10.
    Samii M, Ammirati M, Mahran A, Bini W, Sephernia A (1989) Surgery of petroclival meningiomas. Report of 24 cases. Neurosurgery 24:12–17PubMedCrossRefGoogle Scholar
  11. 11.
    Sekhar LN, Samii M (1986) Petroclival and medial tentorial meningiomas. In: Scheunemann H, Schurmann K, Helms J (eds) Tumors of the skull base. Extra-and intracranial surgery of skull base tumours. de Gruyter, Berlin, pp 141–158Google Scholar
  12. 12.
    Yasargil MG, Mortara RW, Curcic M (1980) Meningiomas of basal posterior cranial fossa. In: Krayenbtihl H (ed) Advances and technical standards in neurosurgery, vol 7. Springer, Berlin Heidelberg New York, pp 3–115Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • Madjid Samii
    • 1
  • Mario Ammirati
    • 2
  1. 1.Medizinische Hochschule HannoverHannover 1Germany
  2. 2.Division of NeurosurgeryOlive View/UCLA Medical CenterLos AngelesUSA

Personalised recommendations