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 , 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.
KeywordsCarbide Drilling Neurol Pyramid Meningioma
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