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Daniel E. Nijensohn, Joao C. Araujo, and Collin S. Maccarty

M eningiomas of Meckel's cave involving the Gasserian ganglion are relatively rare. 12 In a series of 295 intracranial meningiomas, Cushing and Eisenhardt 6 found only five arising in Meckel's cave. There were 14 Gasserian ganglion meningiomas among 1454 intracranial meningiomas seen at the Mayo Clinic from 1914 through 1960, an incidence of 1%. 7 We are reporting the clinical and surgical findings in 12 patients with meningioma of Meckel's cave treated surgically at the Mayo Clinic from 1952 to 1972. Each of the 12 had a histologically verified meningioma

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Madjid Samii, Gustavo A. Carvalho, Marcos Tatagiba, Cordula Matthies, and Peter Vorkapic

T entorial meningiomas are estimated to represent only 2% to 3% of all intracranial meningiomas. 5, 9, 18 Because of the intricate anatomical relationship of the tentorial notch to the surrounding neurovascular structures, 17, 18 meningiomas in this region need to be exactly delineated in their location and extension before surgery. These tumors represent complex surgical entities. The surgical approach, surgical technique, and the postoperative results are the outgrowth of careful analysis and understanding. The tentorial notch or tentorial incisura is

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Trisha P. Gupte, Chang Li, Lan Jin, Kanat Yalcin, Mark W. Youngblood, Danielle F. Miyagishima, Ketu Mishra-Gorur, Amy Y. Zhao, Joseph Antonios, Anita Huttner, Declan McGuone, Nicholas A. Blondin, Joseph N. Contessa, Yawei Zhang, Robert K. Fulbright, Murat Gunel, Zeynep Erson-Omay, and Jennifer Moliterno

M eningiomas are the most common central nervous system tumors, and approximately 30%–40% of patients with meningioma have seizures. 1 , 2 Uncontrolled seizures can significantly affect the quality of life of patients with brain tumors and result in cognitive deterioration. 3–6 While seizure freedom can be achieved in approximately 80% of meningioma patients after surgery, some can experience a recurrence, and nearly 20% of meningioma patients without preoperative seizures can develop seizures postoperatively. 3 , 5 , 7 , 8 Given that worse patient outcomes

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Amr Abdel Kerim, Fabrice Bonneville, Betty Jean, Philippe Cornu, Lise LeJean, and Jacques Chiras

A lthough preoperative embolization of convexity meningiomas remains controversial, this procedure is useful in some cases because it makes the tumor softer and less bloody and thus easier to remove at surgery. 3 Blood supply to meningiomas usually comes from branches of the external carotid artery, but in cases of meningiomas of the skull base, supply might come via the meningohypophyseal trunk or the ILT of the cavernous segment of the ICA. 4 Preoperative embolization of these small and tortuous branches is often difficult and dangerous and carries a

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Hiroki Morisako, Takeo Goto, Hiroki Ohata, Sachin Ranganatha Goudihalli, Keisuke Shirosaka, and Kenji Ohata

M eningiomas arising from the cavernous sinus (CS) are one of the most difficult and challenging brain tumors to remove surgically. Over the last 3 decades, with long-term outcomes of CS meningiomas (CSMs), the surgical strategy has shifted from radical resection to safe maximal removal to achieve local control of the tumor with or without additional radiation therapy. 6 , 7 , 9–11 , 15–17 , 19 , 24 , 26 , 29 , 30 , 31 , 33 , 35 , 37 Several surgical approaches have been reported for CSMs, including the frontotemporal orbitozygomatic approach, frontotemporal

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Roh-Eul Yoo, Tae Jin Yun, Young Dae Cho, Jung Hyo Rhim, Koung Mi Kang, Seung Hong Choi, Ji-hoon Kim, Jeong Eun Kim, Hyun-Seung Kang, Chul-Ho Sohn, Sun-Won Park, and Moon Hee Han

for meningiomas in selected cases to decrease the technical difficulty of resection and maximize the rate of complete resection, given the hypervascular nature of the tumor. 13 Furthermore, information obtained from diagnostic angiography itself, including tumor vascularity or vascular anatomy of feeding arteries and draining veins, can also help surgical planning. 17 Nonetheless, digital subtraction angiography (DSA) is an invasive imaging modality, with reported neurological complication rates ranging from 0.34% to 1.3%. 4 , 16 , 21 More recently, normalized

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Maria Koutourousiou, Juan C. Fernandez-Miranda, S. Tonya Stefko, Eric W. Wang, Carl H. Snyderman, and Paul A. Gardner

D espite technological advances such as image guidance and the use of the operating microscope during the last decades, both of which have improved the surgical outcome in the management of suprasellar meningiomas, the treatment of these tumors remains challenging given the high risk of visual pathway involvement and vascular encasement of the paraclinoidal carotid artery or the anterior cerebral artery (ACA) complex. Various surgical approaches have been advocated to resect suprasellar meningiomas, with the subfrontal approach (unilateral or bilateral

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Amr M. N. El-Shehaby, Wael A. Reda, Khaled M. Abdel Karim, Ahmed M. Nabeel, Reem M. Emad Eldin, and Sameh R. Tawadros

O ne of every 10 intracranial tumors arises in the cerebellopontine angle (CPA), most of which are vestibular schwannomas (VSs), comprising 80%–85%, and less commonly meningiomas, accounting for 10%–15%. 1 , 5 , 45 Because of the close proximity of CPA meningiomas to critical neurovascular structures, resection is surgically challenging. Stereotactic radiosurgery (SRS) as an adjuvant or alternative treatment for skull base meningiomas has demonstrated high efficacy and safety. 32 , 36 , 40 , 42 , 47 However, the presence of the hearing apparatus in the

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Anil Nanda, Jai Deep Thakur, Ashish Sonig, and Symeon Missios

We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time. — T. S. Eliot 14 Cavernous sinus meningiomas (CSMs) represent a subset of intracranial tumors that continue to pose a formidable challenge to neurosurgeons. The various factors contributing to the challenging management of CSMs include not only their location, which limits their resectability and increases the risk of injuring critical neurovascular structures, but also achieving long-term tumor control and

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Da Li, Zhen Wu, Cong Ren, Shu-Yu Hao, Liang Wang, Xin-Ru Xiao, Jie Tang, Yong-Gang Wang, Guo-Lu Meng, Li-Wei Zhang, and Jun-Ting Zhang

F oramen magnum meningiomas (FMMs) have been shown to constitute approximately 1.5%–2.5% of all intracranial meningiomas and 4%–6.5% of their posterior cranial fossa counterparts; approximately 80%–100% are located anteriorly and anterolaterally in most series. 5–7 , 10 , 20 , 27 , 28 , 30 , 31 , 39 , 44 , 49 , 50 , 52 , 57 , 58 , 63 Surgical management of FMMs is challenging and demands great technique. The surgical approach for FMMs has been extensively studied and developed by eminent skull base surgeons. 1 , 5 , 10 , 11 , 14–16 , 21 , 25 , 26 , 28