An extensive cranial base meningioma extending bilaterally into Meckel's cave: case report.
OBJECTIVE
A patient with an extensive cranial base meningioma that included bilateral invasion of Meckel's cave underwent surgical resection and had an unexpected rare complication, malocclusion from bilateral trigeminal dysfunction.


METHODS
A 19-year-old male patient was admitted to our hospital with alternating painful ophthalmoplegia. He had been blind since the age of 10 years. At the time of admission, neurological findings included bilateral visual loss and optic atrophy. Magnetic resonance images showed an extensive tumor located at the planum sphenoidale, tuberculum sellae, and bilaterally at Meckel's cave and the medial tentorial incisura.


METHODS
The patient underwent a two-stage operation. During the first procedure, the masses in the planum sphenoidale, tuberculum sellae, and the left side of Meckel's cave were excised intradurally. At the second operation, the mass in the right side of Meckel's cave was excised extradurally and the tentorial mass was removed intradurally. The patient's postoperative course was complicated by bilateral trigeminal nerve dysfunction, which caused malocclusion.


CONCLUSIONS
Bilateral dysfunction of the trigeminal nerve may cause a number of problems. Thus, extreme caution must be taken to preserve the function of this nerve.
Kinjo
T
T
Department of Neurosurgery, University of the Ryukyus, School of Medicine, Okinawa, Japan.
Mukawa
J
J
Koga
H
H
Shingaki
T
T
D000328:Adult; D003389:Cranial Nerve Diseases / Q000209:etiology; D004292:Dominance, Cerebral / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D019291:Skull Base / Q000473:pathology / Q000601:surgery; D061221:Trigeminal Nerve Injuries