Suprasellar Meningiomas

Abstract

Suprasellar meningiomas originate most frequently from the planum sphenoidale or tuberculum sellae, but they may also originate from the diaphragma sellae or anterior clinoid region. Cushing coined the term chiasmal syndrome to describe the complex of symptoms and signs commonly associated with these lesions: “primary optic atrophy with bitemporal field defects in adult patients showing an essentially normal sella turcica” [2]. Visual symptoms are still the most common presenting symptoms on admission, and the most common first symptom followed by headache [4]. Visual symptoms are asymmetric, starting in one eye, worsening in it, and spreading to the other eye, usually in the form of severe visual loss in the initial eye and decreased acuity in the opposite temporal field [3]. Signs on admission parallel the symptoms with visual signs (visual field defects, loss of visual acuity, optic atrophy) present in almost all patients [11]. In one recent series hypo-osmia was the second most common sign on admission (24%), followed by abnormal mental status and pyramidal signs, with a frequency of 9% each [12].