Pitfalls in surgery of meningeomas of the free tentorial edge.
Clinical experiences from 15 meningeomas located on the free edge of the tentorium are reported. Unexpected findings and complications found in five patients are presented in detail: Despite successful removal without postoperative morbidity after a presigmoid approach the preoperative loss of function of the ophthalmic nerve may cause increasing keratitis, which may result in blindness over the years after surgery. Before a presigmoid approach is performed, angiography or magnetic resonance angiography is advised, because the patient may have only one sigmoid sinus on the tumor side. An acute subdural hematoma as a complication of surgery may not only occur after, but also during surgery with the patient in the semi-sitting position. When a space occupying tumor of the tentorium is discovered, there may be an additional spinal one. If total removal of an extensive tumor of the free edge of the tentorium appears too hazardous, a two-stage strategy with a one year interval may lead to success.
Firsching
R
R
Klinik für Neurochirurgie der Otto von Guericke Universität Magdeburg. neurochirurgie@uni-magdeburg.de
Synowitz
H J
HJ
Grimm
C
C
D000368:Aged; D001259:Ataxia / Q000209:etiology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome