Full endoscopic endonasal transclival approach: meningioma attached to the ventral surface of the brainstem.
Neurocirugia (Astur)
; 25(3): 140-4, 2014.
Article
em En
| MEDLINE
| ID: mdl-24685579
ABSTRACT
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Tronco Encefálico
/
Endoscopia
/
Meningioma
Limite:
Adolescent
/
Female
/
Humans
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article