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Meningioma with holo-sagittal sinus involvement treated successfully with intrinsic sinus surgery: illustrative case

Megan Rajagopal, Jamie Toms, and R. Scott Graham

Meningiomas account for about one-third of all central nervous system tumors. 1 The most common locations are the cerebral convexity (35%) and parasagittal (20%). 2 Meningiomas present a particular challenge when they involve bridging veins and major dural sinuses, as surgical removal may lead to venous congestion, brain swelling, and venous infarction. Parasagittal meningiomas have a grading classification described by Sindou. 3 , 4 Type I describes meningiomas that are attached to the outer surface of the sinus wall. In higher grades, types V and VI, the

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Successful treatment with urgent revascularization and parent artery occlusion for a ruptured intratumoral aneurysm following prior meningioma surgery: illustrative case

Tomohiro Okuyama, Kota Kurisu, Masaaki Hokari, Kei Miyata, Kazuki Uchida, Katsuyuki Asaoka, Koji Itamoto, and Miki Fujimura

pathogeneses of aneurysm development. Completely embedded intratumoral aneurysms are much rarer, 1 and their underlying pathogenesis and association with the surrounding tumor are unknown. Therefore, determining an optimal treatment strategy for such cases is complex. In this case report, we describe a rare case of an intratumoral aneurysm that developed 30 years after meningioma surgery, whose rupture resulted in a massive intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Rupture of this rare aneurysm is an additional rarity and requires urgent and

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Intratumoral abscess complicating a postradiation-induced World Health Organization grade II meningioma: illustrative case

Katherine Callahan, Isidora Beach, Sadie Casale, John DeWitt, and Bruce Tranmer

Meningiomas are the most commonly diagnosed benign primary brain mass, accounting for more than 35% of all brain neoplasms diagnosed annually. 1 In the Western world, brain abscesses occur at a rate of approximately 4 per 1 million annually and are most commonly due to infection by Staphylococcus or Streptococcus bacteria. 2 Peritumoral abscesses are historically associated with intra- or parasellar tumors and have predominantly originated from direct contact with the prenasal sinuses. 3 However, in most reported cases of meningioma-associated abscess

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Manual superficial temporal artery compression using a circular plastic material for embolization of meningioma: illustrative case

Yoshinobu Horio, Koichi Miki, Dai Kawano, Takaaki Amamoto, Hironori Fukumoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, and Hiroshi Abe

Preoperative embolization for meningioma is performed to reduce intraoperative blood loss, decrease blood transfusions, and shorten the operative time. 1–3 In the case of meningiomas that occur in the high-convexity region or near the superior sagittal sinus, the superficial temporal artery (STA) frequently feeds the tumor, 4 and when embolizing from the middle meningeal artery (MMA), the embolic material may not reach the tumor vessels because of the pressure gradient caused by blood flow from the STA, resulting in inadequate embolization. When embolizing

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The management of symptomatic hyperostotic bilateral spheno-orbital meningiomas: patient series

Lauren Harris, Jarnail S Bal, Evangelos Drosos, Samir Matloob, Nicola Y Roberts, Charlotte Hammerbeck-Ward, Omar Pathmanaban, Gareth Evans, Andrew T King, Scott A Rutherford, Jonathan Pollock, and Alireza Shoakazemi

Spheno-orbital meningiomas (SOMs) are benign tumors that can present incidentally or with proptosis and/or visual impairment. Cosmetic impairment explains their early descriptions, including one of the earliest resections by Durante in 1884. 1 Visual symptoms include loss of color vision, deficits of acuity or fields from optic nerve or chiasmal compression, papilledema, diplopia, ptosis, and exophthalmos. 2–4 The tumors are usually slow-growing and can involve the lesser wing of the sphenoid, orbital wall, or orbital roof, with extension into the superior

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Intraoperative MRI for the microsurgical resection of meningiomas close to eloquent areas or dural sinuses: patient series

Constantin Tuleasca, Rabih Aboukais, Quentin Vannod-Michel, Xavier Leclerc, Nicolas Reyns, and Jean-Paul Lejeune

Meningiomas are the most commonly encountered nonglial primary intracranial tumors, with an incidence of approximately 20% of all intracranial tumors. 1 They are more frequent in adults during the fourth through sixth decades of life. 2 , 3 The clinical presentation is variable, unspecific, and depends on tumor anatomical location. 1 Magnetic resonance imaging (MRI) is currently considered the imaging technique of choice and allows assessment of potential mass effect, vascular supply, or degree of the peritumoral edema, as well as accurate localization of

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Fluorescence and immune-cell infiltration of nonneoplastic, postbrachytherapy brain tissue in 5-ALA–guided resection of recurrent anaplastic meningioma: illustrative case

Rishab Ramapriyan, Victoria E Clark, 1 PhD, Maria Martinez-Lage, Brian Hsueh, 1 PhD, Brian V Nahed, 1 MSc, William T Curry, Bryan D Choi, 1 PhD, Bob S Carter, and 1 PhD

5-Aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) has gained prominence in recent years for its utility in high-grade glioma resection, allowing enhanced visualization and tumor removal. 1 The use of 5-ALA for meningioma surgery has also been reported. 2 Mechanistically, 5-ALA is preferentially taken up by cells of certain tumors, including meningiomas, and enters the heme biosynthesis pathway, where it is converted to heme precursor porphyrin PpIX, which then accumulates in cells due to various tumor-specific aberrations, such as altered

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Cerebral arterial vasospasm complicating supratentorial meningioma resection: illustrative cases

Andrew C Pickles, John T Tsiang, Alexandria A Pecoraro, Nathan C Pecoraro, Ronak H Jani, Brandon J Bond, Anand V Germanwala, Joseph C Serrone, and Vikram C Prabhu

Meningiomas are the most frequently diagnosed primary tumor of the central nervous system. 1 , 2 Resection of meningiomas is the first-line treatment, with the extent of removal being inversely related to the rate of recurrence. 3 Preservation of the arachnoid plane around a meningioma facilitates a more complete resection with avoidance of injury to the adjacent cortex. However, at times, pial or brain invasion may complicate identification of the tumor margin. 4 In addition, meningiomas parasitize pial and cortical vessels and can be densely adherent

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Mother and daughter with a SMARCE1 mutation resulting in a cervical clear cell meningioma at an identical location: illustrative cases

Valérie N. E. Schuermans, Ank van de Goor, Martinus P. G. Broen, and Toon F. M. Boselie

Meningiomas are tumors that arise from the dura mater and primarily occur in the brain and spinal cord. 1 Intradural extramedullary meningiomas are the most common, which account for approximately 45% of all intradural spinal tumors. 2 , 3 Extradural spinal meningiomas occur less frequently. 2 Meningiomas are generally benign tumors and are rarely malignant. Because these tumors grow slowly, symptoms often arise when the tumor is already fairly large. Meningiomas are commonly found in all regions of the skull and along the spinal cord. 3 , 4 The majority

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Intracranial aspergilloma mimicking metachronous meningioma following transsphenoidal removal of a tuberculum sellae meningioma: illustrative case

Daisuke Sato, Hirotaka Hasegawa, Hironobu Nishijima, Kyotaro Kawase, Koh Okamoto, Akiko Iwasaki, Yuki Shinya, Masahiro Abe, Yoshitsugu Miyazaki, and Nobuhito Saito

complication following eTSS. Post-eTSS CNS aspergillosis infection has been reported infrequently, usually presenting as a mycotic aneurysm subsequent to vasculitis or a local fungus ball formation. 7–9 Here, we describe a case of CNS aspergilloma that developed over 6 months following eTSS for a tuberculum sellae meningioma in an immunocompetent patient who had concurrent asymptomatic fungal sinusitis at the time of the initial eTSS. Illustrative Case A 58-year-old woman was referred to our department following incidental detection of a tuberculum sellae meningioma