Clinoidal meningiomas

Abstract

Clinoidal meningiomas have distinguishing clinical, radiological, and surgical considerations. They present a surgical challenge and have a notorious rate of recurrence. The best chance of their cure comes through total removal, but the fear of injury to cerebral vessels has led most surgeons to accept subtotal removal. We classify these tumours into three groups according to the presence or absence of an interfacing arachnoid membrane between the tumour and cerebral vessels. The presence or absence of this membrane depends on the origin of the tumour and its relation to the naked carotid segment lying outside the carotid cistern. In Group I, total removal is impossible and results are disappointing. In Groups II and III, total removal is possible and results are good despite arterial encasement by the tumour.