title: Unique Extrancranial-to-Intracranial Neovascularization Found on Diagnostic Angiography Prior to Skull Base Atypical Grade 2 Meningioma Resection: A Case Report and Hypothesis.
abstract: Meningiomas are common intracranial tumors that can have a complex arterial supply. In a patient with a recurrent large left clinoid aypical grade 2 meningioma, diagnostic angiography revealed left proximal middle cerebral artery (MCA) occlusion and reconstitution of the MCA circulation from the left middle meningeal artery. Consequently, the planned surgical approach was adjusted to preserve the left external carotid artery circulation in a difficult meningioma resection. This case illustrates a role for preoperative angiography in surgical planning of patients with complex skull base tumors involving intracranial vascular structures and highlights the unique neovascularization that often occurs as meningiomas parasitize the exracranial blood supply.
authors: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: rui.feng@icahn.mssm.edu.
authors: Rui
authors: R
authors: Feng
authors: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors: Eric Karl
authors: EK
authors: Oermann
authors: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors: Thomas
authors: T
authors: Oxley
authors: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors: Raj
authors: R
authors: Shrivastava
mesh_terms: D002342:Carotid Artery, External; D002533:Cerebral Angiography; D035301:Cranial Fossa, Middle; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008576:Meningeal Arteries / Q000000981:diagnostic imaging*; D008577:Meningeal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008579:Meningioma / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D009389:Neovascularization, Pathologic / Q000150:complications / Q000000981:diagnostic imaging*; D019635:Neurosurgical Procedures; D059351:Organ Sparing Treatments
keywords: Diagnostic cerebral angiography; Meningioma; Skull base tumor