Pablo Barreras Galindo;
San Juan Bautista School of Medicine
Antonio De La Cruz Ramos;
Recinto de Ciencias Medicas
Ismael Lugo Rodoriguez;
San Juan Bautista School of Medicine
Felipe Barreras Galindo;
San Juan Bautista School of Medicine
Fabianna Himet Coll;
San Juan Bautista School of Medicine
Mario Polo Asenjo;
Hospital Menonita; San Juan Bautista School of Medicine
Background
Anterior cranial fossa (ACF) meningiomas account for approximately 6% of all meningiomas. They originate from arachnoid cap cells along the olfactory groove, planum sphenoidale, and tuberculum sellae. Symptoms usually have a gradual onset, and may include headaches and visual changes.
Educational Goals / Teaching Points
The goal of this exhibit is to describe pertinent imaging findings and anatomical relationships of ACF meningiomas, critical in neurosurgical planning. A brief review of the most common transcranial and endonasal surgical approaches in the treatment of ACF meningiomas will also be provided. Tumor recurrence is directly related to the extent of resection of the tumor, the dural attachment and osseous involvement. Therefore, an accurate description of the extent of the tumor, as well as key anatomical and vascular relationships, are crucial to make a report clinically relevant.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging plays a determinant role in the management of meningiomas, including those in the ACF. Magnetic resonance imaging (MRI) and computed tomography (CT) are routinely used in the presurgical evaluation of these tumors. Contrast enhanced MRI accurately depicts the extent of tumor, determines if intraosseous or transosseous extension is present, and defines critical surrounding structures. Transcranial, as well as endoscopic endonasal approaches are both utilized in treating ACF meningiomas, and imaging plays a decisive role in the selection process.
Conclusion
A detailed description of anterior cranial fossa meningiomas should include the tumor’s extent, osseous or transosseous involvement, if any, and the relationship of the tumor with critical surrounding structures. A clinically relevant report will help our neurosurgical colleagues decide the best surgical approach on a case-by-case basis.
