title: Surgical Management of Lateral Tentorial Meningiomas.
abstract: OBJECTIVE
  Tentorial meningiomas represent a heterogeneous group of tumors. Most of the published series deal with either a small number of patients or consider different locations as a whole, making indications for treatment and prognosis difficult to drawn. We analyzed the surgical management of the lateral tentorial meningiomas, a homogenous and rare subgroup.
  
  
  METHODS
  Fifty-two later tentorial meningiomas were operated on between 1990 and 2010. Clinical and radiologic features and surgical management of these patients were reviewed. Tumors were further subcategorized in to posterior/intermediate and in to supra-/infratentorial subgroups. Surgical outcome, long-term results, and prognostic factors are described.
  
  
  RESULTS
  Mean age was 57 years (41 female, 11 male). Mean tumor size was 46 mm; most had an infratentorial location (36 vs. 16). Prevailing presenting symptoms were headache (n = 28), vertigo/gait disturbances (n = 25), and confusion and visual disturbances (n = 16). The infratentorial group presented with a poorer clinical condition before as well as after operation. Extent of tumor resection was Simpson I in 10 patients, II in 26, III in 6, and IV in 10. Subtotal resection was statistically correlated with sinus invasion and tumor size. There was no surgical mortality. Permanent complications occurred in 3 patients. At latest follow-up (mean, 119 months) 42/46 had resumed their normal daily activity. Six cases recurred and remained stable after radiosurgery.
  
  
  CONCLUSIONS
  Lateral tentorial meningiomas are a homogeneous entity characterized by simple surgical approaches and favorable outcome (no mortality and low overall morbidity). Infratentorial location was more frequent and was characterized by poorer outcome. The limiting factors for surgical removal were tumor size and sinus invasion. The latter point strengthens the rationale for their classification into posterior and intermediate.
authors.affiliation: Section of Neurosurgery, Department of Neuroscience, University of Verona, Verona, Italy. Electronic address: antoniobiroli@yahoo.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Biroli
authors.affiliation: Section of Neurosurgery, Department of Neuroscience, University of Verona, Verona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Talacchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D019635:Neurosurgical Procedures; D011183:Postoperative Complications; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Classification; Lateral tentorial meningiomas; Outcome; Review; Surgical management; Tentorial meningiomas