Microsurgical treatment of tentorial meningiomas: Report of 30 patients.
BACKGROUND
Tentorial meningiomas represent about 5% of intracranial meningiomas. This article reviews our recent institutional series of patients with tentorial meningiomas, proposes a simplified classification and analyzes postoperative evolution, discussing the salient features in the management of these patients.


METHODS
From 1998 to 2005, 30 patients (22 female and 8 male) with tentorial meningiomas were operated at our institution. Thirteen patients had tumor restricted to the infratentorial space; 12, to the supratentorial space; and in 5 cases, the tumor involved both compartments. Follow-up ranged from 1 to 8 years. A total of 35 surgical procedures were performed in 30 patients, where 26 procedures were performed through a single approach (2, ITSC; 10, RS; 5, SOIH; 5, ST; and 4, TT); and 9, through combined approaches (7, ITSC/ SOIH; and 2, RS/ST).


RESULTS
Simpson I resection was achieved in 17 patients. Tumors involving both compartments, involving the petrous sinus, and attached to the torcula limited complete resection. Twenty-two out of 30 patients were able to return to their regular life with no or minimal neurological sequelae. Most frequent complications in our series were shunt dependence, CSF fistulae, diffuse brain injury and visual field defects. Overall, our series revealed 3% mortality and 23% morbidity.


CONCLUSIONS
Tentorial meningiomas are associated with significant morbidity related to the nervous and vascular structures surrounding the tumor. Partial tumor removal may be necessary in some cases.
Aguiar
Paulo Henrique
PH
Department of Neurology, São Paulo University Hospital, Dr Eneas de Carvalho Aguiar Avenue, 647 - Cerqueira César, 05403-900, São Paulo, Brazil.
Tahara
Adriana
A
de Almeida
Antonio Nogueira
AN
Kurisu
Kaoru
K