Full endoscopic endonasal transclival approach: Meningioma attached to the ventral surface of the brainstem
| Autor: | Simal Julian JA, Sanroman Alvarez P, Miranda Lloret P, Plaza Ramirez E, Perez Borreda P, Botella Asuncion C |
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| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | NEUROCIRUGIA r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| ISSN: | 1130-1473 |
| Popis: | Background: Intracranial meningiomas without dural attachment (MWODA) are rare entities. We present the first case published, to the best of our knowledge, regarding a MWODA attached to the ventral surface of the brainstem. This location makes the patient subsidiary to treatment through an expanded endonasal transclival approach. Clinical presentation: A 16-year-old female with suspected diagnosis of recurrence of a clear cell meningioma (CCM) at a distance from the initial lesion, located on the premedullary cistern. The patient underwent a pure endoscopic low transclival approach. The attachment to the ventral surface of the brainstem was confirmed intraoperatively. Postoperative MRI confirmed gross total resection and treatment was complemented with adjuvant fractionated stereotactic radiotherapy. No complications related to the procedure were observed. Conclusion: MWODA may appear attached to the ventral brainstem. The expanded endonasal approach to the clivus provides a critical anatomical advantage in the treatment of medial lesions, even ventral meningiomas, to the lower cranial nerves. Reconstruction principles must be strictly respected to reduce complications. (C) 2013 Sociedad Espanola de Neurocirugia. Published by Elsevier Espana, S.L. All rights reserved. |
| Databáze: | OpenAIRE |
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