Meningiomas of the tentorial notch: surgical anatomy and management

Journal of Neurosurgery
M SamiiP Vorkapic

Abstract

Twenty-five meningiomas located at the tentorial notch were surgically treated between 1978 and 1993 at the Neurosurgical Department of Nordstadt Hospital in Hannover, Germany. Nineteen meningiomas were classified as originating from the lateral tentorial incisura (Group I) and six were from the posteromedial tentorial incisura (Group II). Clinically, the most common symptom was trigeminal neuralgia, followed by headache. Neuroradiologically, 64% of the meningiomas were larger than 30 X 30 mm. Further evaluation revealed signs of brainstem compression in 88% of the patients. Radical surgical removal (Simpson I and II) was achieved in 88% of the cases. There was no mortality. Follow up revealed that 80% of patients were able to return to their premorbid activity. Surgical approaches to the tentorial notch included the suboccipital retrosigmoidal or the combined subtemporal-presigmoidal approach for Group I tentorial notch meningiomas; and the supracerebellar-infratentorial or the suboccipital-transtentorial approaches for Group II meningiomas. Because the best surgical approach to the tentorial incisura is still a matter of debate, the anatomy of the tentorial incisura, the clinical presentation of the patients, diagnostic indic...Continue Reading

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Citations

Jun 4, 2008·Neurosurgical Review·Benedicto Oscar ColliCarlos Gilberto Carlotti
May 27, 2011·Neurosurgical Review·Chien-Min ChenYong-Kwang Tu
Nov 1, 2006·Journal of the Association for Research in Otolaryngology : JARO·Minoo LenarzThomas Lenarz
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Methods Mentioned

BETA
surgical resection
pulls
it down
dissect

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