Approach Selection and Surgical Planning in Posterior Cranial Fossa Meningiomas: How I Do It

J Neurol Surg B Skull Base. 2019 Aug;80(4):380-391. doi: 10.1055/s-0038-1675589. Epub 2018 Oct 31.

Abstract

Posterior cranial fossa meningiomas represent approximately 9% of all the intracranial meningiomas. Despite the recent reports of radiation therapy in the management of these tumors, surgical resection continues to be the first line of treatment method aiming the permanent meningioma eradication. The evolution of imaging studies improved the preoperative evaluation of meningiomas providing greater anatomical detail of small structures not previously visualized. Nonetheless, the preoperative radiological evaluation should go beyond the differential diagnosis of a posterior fossa tumor. Anatomo-radiological assessment of meningiomas is discussed in detail. Based on our clinical experience, literature review, and case illustration, we highlight important preoperative anatomo-radiological aspects of posterior fossa meningiomas and their implications in the surgical management of these tumors.

Keywords: cerebellopontine angle meningioma; clival meningioma; foramen magnum meningioma; jugular foramen meningioma; meningioma; petroclival meningioma; posterior fossa; surgical approaches.