Tentorial Meningiomas


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Abstract

Three-dimensional understanding of the pathologic and radiologic anatomy of tentorial meningiomas is the basis for our proposed classification, which provides the rationale for surgical approach for each tentorial location. Safe resection is the surgical goal, whether gross or subtotal resection is used. For each group of tentorial meningioma classified (anterior incisural, middle incisural, falcotentorial, posterolateral and posteromedial, torcular) and the subtypes, consideration is given to the optimal surgical corridor. Particular topics discussed include careful interpretation of the preoperative venous sinus to determine the extent of tumor involvement; devascularization, debulking, and dissection of the tumor with preservation of the arachnoidal plane; and resection of the dural origin as completely as possible.

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