Clivus Meningioma: Six Cases of Total Removal

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Meningiomas which arise from the clivus are extremely rare. According to Dany8), the incidence of this tumor is 8.4% of the meningiomas of the posterior fossa and 0.125% of all brain tumors. The clinical features of the clivus meningioma consist of asymmentrical bilateral cranial nerve involvements (especially V, VII, VIII, IX, X), cerebellar and long tract signs and increased intracranial pressure. Practically, VAG and CAG are the most useful diagnostic procedures.<BR> Results of treatment have been quite disappointing, primarily because of the position of the mass which is anterior to the brain stem and in direct contact with the vertebral and/or basilar artery. Most neurosurgeons would consider it to be inoperable and would simply perform a biopsy or partial removal. However, when the tumor is not too large and hard, total removal of a clivus meningioma should be tried with some precautions. The approach must be chosen to provide the shortest access to the main feeders, and multisided exposure should be obtained according to the location and the extension of the tumor. The results which have been obtained in our own 6 cases are encouraging.

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