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Suprasellar Meningiomas

  • Madjid Samii
  • Mario Ammirati

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].

Keywords

Optic Nerve Anterior Clinoid Process Skull Base Meningioma Olfactory Groove Tuberculum Sellae 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Al Mefty O, Holoubi A, Rifai A, Fox JL (1985) Microsurgical removal of suprasellar meningiomas. Neurosurgery 16:364–372CrossRefGoogle Scholar
  2. 2.
    Cushing H, Eisenhardt C (1962) Meningiomas. Their classification, regional behavior, life history and surgical end results. Hafner, New York, pp 225–241Google Scholar
  3. 3.
    Grant FC (1952) Meningioma of the tuberculum sellae. Arch Neurol Psychiatry 68:411–412Google Scholar
  4. 4.
    Gregorius FK, Hepler RS, Stern WE (1975) Loss and recovery of vision with suprasellar meningiomas. J Neurosurg 42:69–75PubMedCrossRefGoogle Scholar
  5. 5.
    Guiot G, Derome P, Viscot A (1970) Meningeomes suprasellaires retrochiasmatiques. Neurochirurgie 16: 273–285PubMedGoogle Scholar
  6. 6.
    Kadis GN, Mount LA, Ganti SR (1979) The importance of early diagnosis and treatment of the meningiomas of the planum sphenoidale and tuberculum sellae: a retrospective study of 105 cases. Surg Neurol 12:367–371PubMedGoogle Scholar
  7. 7.
    Kempe L (1968) Operative neurosurgery, vol 1. Springer, Berlin Heidelberg New York, pp 94–97Google Scholar
  8. 8.
    Logue V (1979) Surgery of meningiomas. In: Symon L (ed) Operative surgery: neurosurgery. Butterworths, London, pp 128–173Google Scholar
  9. 9.
    MacCarty CS, Piepgras DG, Ebersold NJ (1982) Meningeal tumors of the brain. In: Youmans J (ed) Neurological surgery: a comprehensive reference guide to the diagnosis and management of neurosurgical problems, 2nd edn. Saunders, Philadelphia, pp 2936–2966Google Scholar
  10. 10.
    Morley TP (1973) Tumors of the cranial meninges. In: Youmans J (ed) Neurological surgery: a comprehensive reference guide to the diagnosis and management of neurosurgical problems, 1st edn. Saunders, Philadelphia, pp 1388–1411Google Scholar
  11. 11.
    Ojemann RG, Swann KW (1988) Surgical management of olfactory groove, suprasellar and medial sphenoid wing meningiomas. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques: indications, methods and results, vol 1, 2nd edn. Grune and Stratton, New York, pp 531–545Google Scholar
  12. 12.
    Rosenstein J, Symon L (1984) Surgical management of suprasellar meningioma. II. Prognosis for visual function following craniotomy. J Neurosurg 61:642–648PubMedCrossRefGoogle Scholar
  13. 13.
    Symon L (1977) Olfactory groove and suprasellar meningiomas. In: Krayenbuhl H (ed) Advances and technical standards in neurosurgery, vol 4. Springer-Verlag, Berlin Heidelberg New York, pp 67–91CrossRefGoogle Scholar
  14. 14.
    Symon L, Rosenstein J (1984) Surgical management of suprasellar meningioma. I. The influence of tumor size, duration of symptoms and microsurgery on surgical outcome in 101 patients. J Neurosurg 61:633–641PubMedCrossRefGoogle Scholar
  15. 15.
    Yasargil MG (1984) Microneurosurgery, vol 1. Thieme, Stuttgart, pp 92, 108Google 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

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